Student Name:
RA
……………………………………
Student Number: …………………………………....
Unit Topics: Work within a structured counselling framework; Support clients in
decision making processes
Unit Codes: CHCCSL501A; CHCCSL507B
STUDY GUIDE 1
COUNSELLING AND
THE COUNSELLING PROCESS
Published by: Australian Institute of Professional Counsellors Pty Ltd ATF AIPC Trust
ACN 077 738 035
All Case Histories in this text are presented as examples only
and any comparison which might be made with persons either
living or dead is purely coincidental.
Fourth Edition, August 2015
Copyright ownership: Australian Institute of Professional Counsellors Pty Ltd ATF AIPC Trust
ACN 077 738 035
This book is copyright protected under the Berne Convention.
All rights reserved. No reproduction without permission.
Australian Institute of Professional Counsellors
Head Office
47 Baxter St., Fortitude Valley, QLD 4006.
This book is protected by copyright and may not be reproduced or copied either in part or in whole nor
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Professional Counsellors Pty Ltd ATF AIPC Trust ACN 077 738 035) of the copyright
Contents
Unit Overview.................................................................................................................................................... 5
Assessment .................................................................................................................................................. 6
How to Use This Study Guide ............................................................................................................... 7
Unit Outcomes............................................................................................................................................ 8
INTRODUCTION ............................................................................................................................................. 13
SECTION 1 ........................................................................................................................................................ 15
INTRODUCTION TO COUNSELLING ....................................................................................................... 16
What is counselling? ............................................................................................................................... 16
The history of counselling .................................................................................................................... 17
Counselling vs. other helping professions ..................................................................................... 18
An introduction to counselling theories ......................................................................................... 19
An introduction to human life stage development .................................................................... 22
SECTION 2 ........................................................................................................................................................ 27
USING A STRUCTURED COUNSELLING PROCESS............................................................................. 28
The purpose of structuring .................................................................................................................. 28
The basic counselling structure .......................................................................................................... 29
Clarifying the client’s understanding and expectations ............................................................ 31
Supporting clients in decision-making processes....................................................................... 33
SECTION 3 ........................................................................................................................................................ 37
THE HELPING RELATIONSHIP ................................................................................................................... 38
Building rapport ....................................................................................................................................... 38
Microskills ................................................................................................................................................... 39
Obstacles to the counselling process .............................................................................................. 42
SECTION 4 ........................................................................................................................................................ 47
COUNSELLOR RESPONSIBILITIES ............................................................................................................ 48
Supervision................................................................................................................................................. 48
Counsellor responsibilities to clients ................................................................................................ 49
Counsellor responsibilities to their organisation ......................................................................... 55
3
Study Guide 1: Counselling and the Counselling Process
READINGS A – G ............................................................................................................................................ 57
Reading A ................................................................................................................................................... 59
Reading B .................................................................................................................................................... 75
Reading C.................................................................................................................................................... 85
Reading D ................................................................................................................................................... 99
Reading E ................................................................................................................................................. 105
Reading F ................................................................................................................................................. 111
Reading G ................................................................................................................................................ 117
4
Unit Overview
Unit Overview
Unit Title
CHCCSL501A – Work within a structured counselling framework.
CHCCSL507B – Support clients in decision making processes
Unit Purpose
These two units describe the knowledge and skills required to work within an agency’s agreed
counselling model, as well as support clients in planning a course of action.
Prerequisites
There are no pre-requisites for this unit.
Content

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Introduction to counselling
Structured counselling
The helping relationship
Counsellor responsibilities
Resources/Readings
Readings A – G are located at the end of this Study Guide.
Suggested Hours
Although everyone will work at their own pace, we suggest you allow approximately 100 hours
to complete this unit competently, including seminars, tutorials, assignments and any practical
activities.
Time Frame
The recommended time frame for Unit 1 – Counselling and the Counselling Process is 4
weeks.
Please note that Austudy/Abstudy students must keep to the Austudy/Abstudy Assessment
Due Dates on the Course Outline. Failure to do so may result in your benefit being revoked.
Remember to notify the Institute of your Austudy/Abstudy acceptance.
5
Study Guide 1: Counselling and the Counselling Process
Assessment
This unit will be assessed by completing Assessment Book 1 and an additional Practical
Assessment. You are required to complete all Assessment Book questions successfully
including written assignments, case studies, research projects and exercises as required.
You have several options for submitting your completed Assessment Book:

Via the Online Resource Centre (ORC). You have been provided with your login to
the ORC in your enrolment pack. You can also register to access the ORC at
www.aipc.net.au by clicking on Students and then clicking on the ONLINE
RESOURCE CENTRE button. Instructions are provided to guide you through
completing your Assessment Book and submitting it for online marking. Use of the
ORC will significantly reduce the time and cost involved in posting your Assessment
Book for marking. This is the most efficient submission method.

After registering, if you are unable to upload the document via the ORC, email the
document as an attachment to education@aipc.net.au

If you cannot access the assessment book, then type the answers to the questions in
an editable Word document and email the document as an attachment to
education@aipc.net.au. If you use this option, please include the unit title, Assessment
Book edition – month and year (found on the inside cover of the Assessment Book),
as well as your name and student number on the first page. You must also clearly label
the section and question numbers for ALL your responses. Submissions that do not
meet these guidelines will be returned unmarked.

Completing a printed copy of your assessment book by hand. Please ensure you write
clearly in either blue or black pen (no pencil please). Failure to submit clean, legible
Assessment Books will unfortunately result in these being returned to you, unmarked.
Should you need more space to complete questions, please attach another page to the
relevant Assessment Book page and ensure any additions are clearly marked at the top
of the page with:
− your name
− student number
− the unit code and title
− section number and title
− the question number your additional page refers to
Submit your completed Assessment Book by post to the address below:
Address:
The Australian Institute of Professional Counsellors
Locked Bag 15
FORTITUDE VALLEY
QLD 4006
If posting your Assessment Book, please take a copy (in case of loss in the mail) before
posting it. Please be aware that although we endeavour to mark your work within 3
weeks of receiving it, you might not receive your books until a much later date due to
the postal process involved.
6
Unit Overview
How to Use This Study Guide
This Study Guide contains all of the information that you need to complete the assessment
tasks associated with this unit. You must read through all of the information provided (both
the Study Guide and associated Readings) before attempting the assessment tasks.
Throughout this Study Guide there are a few icons used to help you. These include:
The Tip Icon
This is used to indicate the presence of tips or additional instructions
that may assist you as you work through this Study Guide. You will
usually find them at the beginning of each Section of the Study Guide
to indicate which Readings supplement the information provided in that
Section.
The Reading Icon
You will find these throughout the Study Guide. They indicate that a
particular Reading contains additional information on the topic that is
being discussed at that point.
Reading A
The Reflect Icon
This indicates a self-reflection question. You are not required to submit
answers to these questions. They are designed to get you thinking more
about the topic and to consider key points in order to aid your
understanding.
The Assessment Icon
This is an assessment icon. It indicates the presence of assessment
questions.
Thank you for choosing to study with The Australian Institute of Professional Counsellors.
Best Wishes!
7
Study Guide 1: Counselling and the Counselling Process
Unit Outcomes
Upon completion of this unit, you should be able to:
Element
CHCCSL501A/01
Use a structured approach to
counselling
Performance Criteria
1.1 Use initial session to gather information as
a foundation for counselling process
1.2 Follow a structured approach to counselling
work based on client needs and
expectations
1.3 Explain counselling process to clarify
client’s understanding and expectation
CHCCSL501A/02
Establish the nature of the helping
relationship
2.1 Enable clients to understand the nature of the
counselling service on offer
2.2 Clarify, confirm or modify clients’
expectations of the counselling service
2.3 Identify any anxieties about the counselling
process and explore with clients
2.4 Acknowledge and respect clients’
immediate concerns
2.5 Clarify both expectations and commitment
to the counselling relationship and confirm
with clients
2.6 Identify indicators of client issues requiring
referral and report or refer appropriately, in
line with organisation requirements
2.7 Develop a plan for counselling and
contract with client as required to address
disclosure and organisation/service
requirements
CHCCSL501A/03
Confirm the appropriateness of the
helping relationship.
3.1 Ensure own level of skill and knowledge of
counselling methods and resources are
appropriate to meet client needs
3.2 Explore alternatives to the proposed
relationship with clients where appropriate
3.3 Affirm significance of what the client says
3.4 Promote clients’ understanding of what
they have a right to expect from the service
8
Unit Overview
Element
CHCCSL507B/01
Assist clients in clarifying their aims
and requirements
Performance Criteria
1.1 Clearly explain to clients the policy on
record keeping and confidentiality
1.2 Encourage clients to identify and explore
overall aims, requirements, and ideas for
meeting them
1.3 Encourage clients to feel at ease and express
themselves
1.4 Identify practical goals and requirements,
and discuss with clients how these might be
modified
1.5 Identify with clients potential courses of
action for meeting individual aims and
requirements
1.6 Where aims and requirements of clients
cannot be met, refer clients to appropriate
alternative sources of guidance and support
1.7 Identify indicators of client issues requiring
referral and report or refer appropriately, in
line with organisation requirements
CHCCSL507B/02
Enable clients to explore possible
courses of action
2.1 Explore with client factors which could
influence the preference for and ability to
achieve a course of action.
2.1 Explore with clients features of and likely
consequences of possible courses of action.
2.3 Check client understanding of what is
involved.
2.4 Help clients to assess advantages and
disadvantages of each possible course of
action, and their overall appropriateness for
meeting particular client requirements.
2.5 Encourage clients to decide on a course of
action and to consider alternatives which
could be used if necessary.
2.6 Document decisions and agreed support
within organisation guidelines
ESSENTIAL KNOWLEDGE FOR CHCCSL501A
The candidate must be able to demonstrate essential knowledge required to effectively do
the task outlined in elements and performance criteria of this unit, manage the task and
manage contingencies in the context of the identified work role.
9
Study Guide 1: Counselling and the Counselling Process
These include knowledge of:
 Background knowledge of the counselling process including:
 purpose of counselling
 how counselling has evolved as a helping relationship
 place of counselling within the helping services
 scope of counselling relationship, including professional limitations
 Ethical responsibilities in providing counselling
 Rights of clients involved in counselling
 Counselling context, process and goals
 Knowledge of theories supporting the counselling process
 Human Life Stage development
ESSENTIAL SKILLS FOR CHCCSL501A
To achieve the performance criteria, the following skills are required. These include the ability
to:
 Work within the counselling framework
 Manage own values so they do not impede effective work and managing stress of the
work
 Develop empathy and rapport
 Demonstrate application of skills in
- Active listening
- Respectful responding
- Well timed challenging
- Attention to counselling relationship
- Contracting appropriate to context
RANGE STATEMENT FOR CHCCSL501A
Nature of the counselling service:
 Context and resources of agency
 Preferred counselling model/s of agency
Counselling methods:
 Are according to agency policy and procedures
Client issues requiring referral may include, but are not limited to:
 Child protection issues
 Suicide prevention/intervention
 Domestic and family violence
 Mental health issues
 Alcohol and other drugs issues
ESSENTIAL KNOWLEDGE FOR CHCCSL507B
The candidate must be able to demonstrate essential knowledge required to effectively do the
task outlined in elements and performance criteria of this unit, manage the task and manage
contingencies in the context of the identified work role.
These include knowledge of:
 Referral protocols
 Necessary self awareness including:
10
Unit Overview
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- Role within the organisation
- Limits of competence and responsibility
- Personal strengths and limitations
- Individual needs for support and supervision
- Capacity to be non-judgemental and/or difficulty with this
Agency/organisation model/s of counselling and intervention
Indication of physical or mental ill health
Key and major psychology theories
Obstacles to counselling process
Human life stage development
Policy and principles and procedures to secure and maintain confidentiality including
note-taking, record and log keeping and identity protection
Relevant legislation and ethical code of practice
Development of a range of possible interventions
ESSENTIAL SKILLS FOR CHCCSL507B
It is critical the candidate demonstrate the ability to:
 Work within the counselling framework.
 Managing own values so they do not impede effective work and managing stress of the
work
 Demonstrate application of skills in:
- Problem solving
- Counselling processes and methods
- Respect for client strengths or particular needs
- Capacity to maintain and critique realistic limits for agency service and client
expectations.
 Maintain documentation as required, including effective use of relevant information
technology in line with work and safety (WHS) guidelines.
RANGE STATEMENT FOR CHCCSL507B
Referral may include to specialist services/agencies such as:
 Medical
 Psychiatric
 Grief and Loss
 Various compulsions (such as gambling)
 Financial counselling
Client issue requiring referral may include, but are not limited to:
 Child protection issues
 Suicide prevention/intervention
 Domestic and family violence
 Mental health issues
 Alcohol and other drugs issues
11
Study Guide 1: Counselling and the Counselling Process
12
INTRODUCTION
13
Study Guide 1: Counselling and the Counselling Process
Introduction
About this Unit:
This unit is designed to provide you with an introduction to counselling. The counselling
process you will learn in this unit offers a framework from which you can structure your own
counselling sessions and may assist you in later units when you study more specific counselling
strategies and approaches.
Overview of Sections:
Section 1: Introduction to counselling
In the initial section of this Study Guide you will be introduced to the profession of
counselling. You will learn about the purpose of counselling and how counselling has evolved
as a helping profession. You will also be introduced to several of the major counselling theories
and approaches that will be expanded upon later in the course.
Section 2: Using a structured counselling process
This section explains the need to structure the counselling process so that the counsellor and
client work through specific phases to reach their desired outcomes. You will be introduced
to one general counselling structure and a counselling structure that can be used for problem
solving. You will also learn how to discuss structuring with clients and confirm the client’s
commitment using a counselling contract.
Section 3: The helping relationship
This section introduces you to the importance of the counselling or helping relationship. You
will learn about developing rapport with your client using microskills, as well as some of the
obstacles that may occur during the counselling process.
Section 4: Counsellor responsibilities
Counsellors must always be mindful of their responsibilities and meeting the client’s needs.
This section explores key issues that counsellors must be aware of, such as client rights within
the counselling process and ensuring that the counsellor’s level of skill and knowledge of
counselling methods is appropriate for the task at hand. Issues of referral will also be explored.
Important note: Readings A – G are located at the end of this Study Guide.
Important note to students: The Readings contained in this Study Guide are a collection of extracts
from various books, articles and other publications. The Readings have been replicated exactly from their
original source, meaning that any errors in the original document will be transferred into this Study Guide. In
addition, if a Reading originates from an American source, it will maintain its American spelling and
terminology. The Australian Institute of Professional Counsellors is committed to providing you with high
quality study materials and trusts that you will find these Readings beneficial and enjoyable.
14
Section 1
INTRODUCTION TO
COUNSELLING
15
Study Guide 1: Counselling and the counselling process
Introduction to Counselling
About this Section:
In this section you will learn about:
− The purpose of counselling
− The history of counselling and how it has evolved as a helping profession
− The place of counselling among the helping professions
− The theoretical influences on counselling
− The major counselling approaches
Supporting materials:
The following materials supplement the information provided in this section:
1. Reading A
Welcome to your Diploma of Counselling! Throughout this course, you will be introduced to
the world of counselling, including the many different approaches and skills that will assist you
in your practice. Before we delve too deeply into what counselling involves, it is useful to have
a basic understanding of the theoretical roots of counselling and therapy. This section will
provide you with a brief overview of the development of counselling as a profession, as well
as some of the major counselling theories.
While you are working your way through this Study Guide, it is important to remember that
the information provided in this introductory unit is simply a brief overview. You will learn
much more about specific counselling skills and approaches as you progress throughout the
course. The goal at this stage is to lay the groundwork on which you will continue to build
your skills and knowledge, both throughout this course and onwards throughout your career.
You will also notice a number of self-reflection questions included within the Study Guides of
this course. They are provided to assist you with thinking about the material you are learning
and do not require a written response. Simply take a few minutes to reflect upon your learning.
The ability to reflect is vital for a counsellor.
What is counselling?
“Counselling is fundamentally based on conversation, on the capacity of people to 'talk
things through' and to generate new possibilities for action through dialogue.”
(McLeod, 2013, p. 8)
Reading A
The basic purpose of counselling is to provide a client with a confidential, safe and supportive
environment where they can tell their story, work through their emotions, and make positive
changes to their life. The role of the counsellor is to facilitate the client’s self-development by
providing the client with an opportunity to gain a better understanding of who they are, where
they want to be, and how to get there. The counsellor supports the client to achieve their goals
and gain greater insight into their lives. Furthermore, effective counsellors assist clients to
build skills that they can use to solve other difficulties in their lives For example, if a client
16
Section 1: Introduction to counselling
learns good communication skills to help resolve a problem with their spouse, they will also
be able to use those communication skills with their children, friends, or co-workers.
Self-reflection
What does the term ‘counselling’ mean to you? What ideas or notions about the purpose of
counselling or the role of a counsellor do you currently have?
Consider the various definitions of counselling that are presented in Reading A. Which of
these do you identity with most? Why?
The history of counselling
The origins of counselling can be traced back to the beginning of the eighteenth century when
the industrial revolution brought large-scale changes to society. Before that time, people lived
in small rural communities and the head of the local church would usually deal with emotional
and interpersonal problems. People with more serious mental disturbances were tolerated and
even cared for by the community. However, after the community fragmentation that resulted
from the industrial revolution, there was a shift towards placing people with a mental illness
into asylums. The medical profession took control of these asylums, and towards the end of
the nineteenth century, the medical specialisation of psychiatry emerged (psychiatry is the
science of treating mental diseases). It was from this new field of medicine that psychotherapy
evolved. Counselling shares some of the philosophies and methods of psychotherapy, but, as
the extract below illustrates, it has stronger connections to social reform and a strong presence
in the voluntary sector.
“The history of psychotherapy has been much more fully documented than the history of
counselling. Counselling as a distinct profession came of age only in the 1940s. One of the
public markers of the emergence of counselling at that time was that Carl Rogers, in the face
of opposition from the medical profession to the idea that anyone without medical training
could call himself a ‘psychotherapist’, began to use the term ‘counselling and psychotherapy’
to describe his approach (Rogers, 1942). Although in many respects counselling, both then
and now, can be seen as an extension of psychotherapy, a parallel activity or even a means of
‘marketing’ psychotherapy to new groups of consumers, there are also at least two important
historical strands that differentiate counselling from psychotherapy: involvement in the
educational system and the role of the voluntary sector. The American Personnel and
Guidance Association, which was later to become the American Counselling Association was
formed in 1952, through the merger of a number of vocational guidance professional groups
that were already well established by that time. The membership of the American Personnel
and Guidance Association consisted of counsellors who worked in schools, colleges, and
career advisory services. In Britain, the Standing Council for the Advancement of Counselling,
which was later to become the British Association for Counselling was inaugurated in 1971,
by a network of people who were primarily based in social services, social work and the
voluntary sector.
The precursors to the formation of these organizations can be understood in terms of a sense
of crisis within society, or ‘moral panic’, around various areas of social life. In effect, what
happened was that there was a sense of unease around some aspect of the breakdown of social
order, or the identification of groups of individuals who were being unfairly treated in some
way. These crises were characterized by widespread publicity about the problem, debate in
newspapers and magazines, and efforts to bring about political or legislative change. At some
17
Reading A
Study Guide 1: Counselling and the Counselling Process
point in this process, someone would have the idea that the best means of helping was to treat
each person needing assistance as an individual, and that the most effective way to proceed
was to sit down with that individual, discuss the matter, and find the best way forward for that
person in terms of his or her unique needs and circumstances. The idea of ‘counselling’ appears
to have emerged more or less simultaneously, in many different fields of social action, in this
manner.”
(McLeod, 2013, pp. 31-32)
From the extract (and the remainder of Reading A), we can see that while counselling has
connections to the psychotherapeutic approach that arose out of medicine/psychiatry,
counselling as we know it today has broader social origins. Modern counselling:

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Has a strong footing in social services
Arose as a form of social action
Sees individuals as having unique needs and circumstances
Has a connection with righting injustice
Views client problems and issues within their social context
Has a collaborative focus
There has also been a proliferation of different counselling approaches, including cognitivebehavioural therapy, person-centred therapy, gestalt therapy, solution focused therapy and
narrative therapy (which you will learn about in detail later in this course).
Counselling vs. other helping professions
There are several key similarities and differences between counsellors and other types of
helping professionals.
Counsellors assist people to identify and define their emotional issues and better understand
themselves by explaining options, setting goals, providing therapy, and helping them to take
action.
Psychologists study human behaviour and the processes involved in how people think and
feel. They conduct research and provide treatment and counselling in order to reduce distress
and behavioural and psychological problems, and promote mental health and positive
behaviour in individuals and groups. Psychologists work on a broad range of issues with
clients, including children, adults, couples, families, and organisations.
Social workers help people to deal with personal and social problems, either directly or by
planning or carrying out programmes that benefit groups or communities.
Psychiatrists diagnose, treat and try to prevent human mental, emotional, and behavioural
disorders. Unlike counsellors, psychologists, and social workers, psychiatrists have a medical
degree and the authority to prescribe medicines.
(Adapted from Myfuture, 2013)
Each of the professions listed above have distinct duties, however, there can be significant
overlap. For example, psychologists, social workers, and psychiatrists can draw upon
counselling principles and techniques within their work. Despite their differences, all four
professions are committed to improving people’s physical, social, and emotional quality of life.
18
Section 1: Introduction to counselling
Self-reflection
Are there any other key differences between counsellors and other helping professions that
you can identify?
What do you think is the most important difference that separates counsellors from the other
helping proffesionals? Why do you think that is important?
An introduction to counselling theories
There are many different types, approaches, and theories of counselling and therapy. Some
counsellors only practice one type of counselling (e.g., cognitive behavioural therapy or
person-centred therapy); whilst others use a variety of techniques taken from a range of
approaches. This is known as taking an “eclectic” approach. As you grow and develop your
counselling skills, you may find yourself developing a preference for a particular style of
counselling or you may change your approach depending upon the client and their needs.
All counselling approaches are built on theoretical foundations that help to explain how and
why a person has become who they are and how they can make changes to their lives. Before
learning about the different styles of counselling, it is helpful to understand the theoretical
foundations that have influenced counselling and shaped these approaches.
Why are counselling theories important?
A common question at this stage of a counsellor’s development is: “Why are counselling
theories important?” The answer to this question is that theories provide counsellors with a
framework from which to work. As Nelson-Jones (2014) explains, counsellors are decision
makers – as a counsellor, you will be constantly making choices about how to think about your
client’s behaviour and how to respond. Understanding the various counselling theories will
provide you with a range of concepts that you can draw from in order to think systematically
about human development and behaviour as well as provide you with a framework from which
to inform your interventions and approach with individual clients.
We will now outline some of the major theories that inform specific counselling approaches.
Please note, these are just brief overviews of the different theories. You will learn more about
them in future units of this course.
1. Psychoanalytic theory
Psychoanalytic theory was introduced around the turn of the 20th century by Sigmund Freud.
Freud contributed much to the field, including his beliefs about the unconscious, the role of
child development and memories, and defence mechanisms (Kottler & Shepard, 2015). Freud
believed that people’s problems could be alleviated by bringing unconscious material into
consciousness and having people experience their repressed memories and emotions. The
most important concepts within Freud’s work and psychoanalytic theory include:

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The role of the unconscious
The structure of personality
The psychosexual stages of development
The importance of the past and childhood experience
The use of ego defence mechanisms
Transference and the nature of the therapeutic relationship
The significance of dreams
Free association, or the ‘talking cure’
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Study Guide 1: Counselling and the Counselling Process

Interpretation
(Hough, 2014, p. 77)
Other prolific theorists within psychoanalytic theory include Carl Jung, Alfred Adler, and Erik
Erikson (Kottler & Shepard, 2015). By today’s standards, many of these theorists and their
concepts are now considered controversial; however, their contribution to the profession of
counselling is important. Note: You will learn more about Freud in Study Guide 4 –
Personality and Development Theories.
2. Cognitive/behavioural theory
The current cognitive behavioural approach to counselling is an amalgamation of two
theoretical orientations, the behavioural and the cognitive approaches:
Behavioural therapy
Behavioural therapy stems from the theoretical concept of behaviourism – the “scientific
study of behaviour based on observable actions and reactions” (Hough, 2014, p. 240).
Behaviourists believe in the importance of the interaction between human behaviour and the
environment. Theorists such as Ivan Pavlov and B. F. Skinner used their work with animals
to show that humans are “conditioned” by their environments to behave in certain ways.
Behaviour modification is used to assist clients in changing their behaviours. Note: These
theories will be discussed in more detail in Study Guide 5 – Learning Theories.
Cognitive therapy
Cognition refers to the “experience of thinking, reasoning, perceiving, and remembering”
(Hough, 2014, p. 238), therefore, cognitive therapy is concerned with a person’s thinking and
reasoning. Cognitive theorists are different to behaviourists in that they consider “problems
to arise not directly from events themselves but from how the individual interprets and creates
meaning from them” (Milne, 2010, p. 192). Cognitive therapy uses cognitive restructuring
to help clients change their faulty or destructive thinking processes (Hough, 2014). Prolific
cognitive therapists include Aaron Beck and Albert Ellis.
Cognitive behavioural therapy
Known as CBT, cognitive behavioural therapy combines behaviour modification from
behavioural therapy with cognitive restructuring from cognitive therapy (Pennington, 2013).
CBT practitioners believe that thoughts, feelings, and behaviours are interrelated (Barkway,
2013). The goal of CBT is to help the client uncover and alter distortions in their thinking
which cause psychological distress. CBT is one of the most widely used approaches today.
Note: Cognitive behavioural therapy will be discussed in more detail in Study Guide 6 –
Cognitive Behavioural Therapy.
3. Humanistic
Before the 1950s, counselling and therapy was dominated by psychoanalysis and behaviourist
theories (McLeod, 2013). Humanistic theory emerged during the 1950s as an alternative to
these approaches. The humanistic school of thought focuses on the uniqueness and innate
worth of each individual and the capacity of humans to grow and reach their full potential.
Humanistic theory postulates:
1. Human beings, as human, supersede the sum of their parts. They cannot be reduced
to components.
2. Human beings have their existence in a uniquely human context, as well as in cosmic
ecology.
20
Section 1: Introduction to counselling
3. Human beings are aware and aware of being aware – i.e., they are conscious. Human
consciousness always includes an awareness of oneself in the context of other people.
4. Human beings have some choice and, with that, responsibility.
5. Human beings are intentional, aim at goals, are aware that they cause future events,
and seek meaning, value and creativity.
(McLeod, 2013, pp. 166-167)
Influential to the field of humanstic theory were Carl Rogers and Abraham Maslow. Maslow
developed the hierachy of needs model (see diagram below) that suggests that lower-level
needs (those at the bottom of the triangle) must be satisfied before higher-level needs can be
met (Nevid, 2013). Self-actualisation (the fulfilment of one’s full potential) can only occur
once the needs in the first four levels of the triangle have been met.
Rogers is credited with the development of person-centred (or ‘client-centred’) counselling.
He identified three core conditions that are necessary for clients to make progress: empathy,
unconditional positive regard, and congruence or genuineness (Hough, 2014). The basic
theory of person-centred counselling suggests that if the counsellor is successful in conveying
genuineness, unconditional positive regard, and empathy, then the client will respond with
constructive changes (Wedding & Corsini, 2014). Note: Person-centred therapy is discussed
further in Study Guide 7 – Person-Centred Therapy.
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Study Guide 1: Counselling and the Counselling Process
4. Postmodern approaches
A number of other counselling approaches have emerged from the late 20th century onwards.
In what are known as “postmodern” versions of counselling, counsellors focus on
deconstructing beliefs and examining their value within an individual’s life.
“The postmodern mindset argues for the acceptance of multiple culturally determined realities,
all of equal validity. Postmodern/constructivist therapists endeavour to help clients rewrite
their personal narratives and to reframe their lives”
(Jones-Smith, 2012, p. 291)
Postmodern approaches come from a strengths-based perspective and help to empower
the client rather than focusing on problems and deficits. The two postmodern approaches that
you will learn about in this course are narrative and solution-focused therapy.
Solution-focused therapy
According to Corey (2013, p. 400), solution-focused therapy is “a future-focused, goaloriented therapeutic approach” that focuses on client strengths and encourages clients to
consider what their preferred future would look like. It is the counsellor’s job to help clients
identify their strengths and past successes and work towards their goals and preferred future.
Note: Solution focused therapy is discussed in more detail in Study Guide 9 – Solution
Focused Therapy.
Narrative therapy
In narrative therapy, counsellors help clients to separate themselves from their problems and
view their lives from a different perspective (Kottler & Shepard, 2015). There are several
central premises to narrative therapy:
1. The meaning people give to their lives is shaped by the stories they tell themselves;
2. These stories can constrict their lives and are often influenced by the dominant culture
in which they live;
3. The proper focus of counselling should be helping people examine and “re-author”
their stories.
(Kottler & Shepard, 2015, p. 139)
Note: Narrative therapy is discussed in more detail in Study Guide 10 – Narrative Therapy.
An introduction to human life stage development
Other theories that have strongly influenced counselling practice relate to human development
and change across the lifespan. According to Zastrow and Kirst-Ashman (2013),
understanding of human development helps counsellors to know what behaviours are
“normal” or appropriate and what are not. Additionally, many of the issues that clients bring
to counselling are a result of changes across the lifespan. By considering theories of lifespan
development, counsellors can have a better understanding of the various difficulties clients
face at different points in their lives. We will briefly explore three key developmental theories
over the following pages.
1. Freud’s Psychosexual Stages
In addition to the concepts discussed earlier in this section, Freud also had an important
influence on the understanding of human development. While revolutionary at the time,
Freud’s theories about the psychosexual stages of development are considered controversial
22
Section 1: Introduction to counselling
in counselling today. However, it is important to know about them and understand how the
field of counselling has been affected by developmental theories. The following table outlines
the stages that Freud believes humans go through.
Freud’s Psychosexual Stages
Psychosexual
Period of
Stage
Development
Oral
Description
Birth-1 year
The new ego directs the baby’s sucking activities toward
breast or bottle. If oral needs are not met appropriately,
the individual may develop habits such as thumb
sucking, fingernail biting, and pencil chewing in
childhood and overeating and smoking in later life
Anal
1-3 years
Toddlers and preschoolers enjoy holding and releasing
urine and faeces. Toilet training becomes a major issue
between parent and child. If parents insist that children
be trained before they are ready, or if they make too few
demands, conflicts about anal control may appear in the
form of extreme orderliness and cleanliness or
messiness and disorder.
Phallic
3-6 years
As preschoolers take pleasure in genital stimulation,
Freud’s Oedipus conflict for boys and Electra conflict
for girls arise. Children feel a sexual desire for the other
sex parent. To avoid punishment, they give up this
desire and adopt the same sex parent’s characteristics
and values. As a result, the superego is formed, and
children feel guilty each time they violate its standards.
Latency
6-11 years
Sexual instincts die down, and the superego develops
further. The child acquires new social values from adults
and same sex peers outside the family.
Genital
Adolescence
With puberty, the sexual impulses of the phallic stage
reappear. If development has been successful during
earlier stages, it leads to marriage, mature sexuality, and
the birth and rearing of children. This stage extends
through adulthood.
Source: Adapted from Berk (2014, p. 16)
Self-reflection
Freud’s psychosexual stage theory is often reflected in mainstream ‘pop-psychology’. Have
you ever heard of someone being referred to as “anal” because they are a very tiny or ordered
individual? What about someone saying that they have an “oral fixation”? Have you previously
heard of the Oedipus or Electra complex? Take some time to re-read the above table – can
you see where these expressions have come from?
2. Erikson’s Psychosocial Stages
According to Erikson, our personalities are a result of the interaction between our biologically
determined maturation and the demands placed upon us by society (Zastrow & Kirst-Ashman,
2013). The degree to which we resolve these demands at each stage will influence our ability
to resolve demands at later stages. Erikson’s stages are based partly on Freud’s stages, however,
23
Study Guide 1: Counselling and the Counselling Process
unlike Freud, Erikson extended his theory across the lifespan (Hough, 2014). The table below
outlines Erikson’s psychosocial stages.
Erikson’s Psychosocial Stages
Psychosocial
Period of
Stage
Development
Basis trust vs.
mistrust (oral)
Birth-1 year
Autonomy vs.
shame and
doubt (anal)
1-3 years
Generativity
vs. stagnation
Middle
adulthood
Description
From warm, responsive care, infants gain a sense of
trust, or confidence, that the world is good. Mistrust
occurs when infants have to wait too long for comfort
and are handled harshly.
Using new mental and motor skills, children want to
choose and decide for themselves. Autonomy is
fostered when parents permit reasonable free choice
and do not force or shame the child.
3-6 years
Initiative vs.
Through make-believe play, children explore the kind of
guilt (phallic)
person they can become. Initiative – a sense of ambition
and responsibility develops when parents support their
child’s new sense of purpose. When parents demand too
much self control, they induce excessive guilt.
6-11 years
Industry vs.
At school, children develop the capacity to work and
Inferiority
cooperate with others. Inferiority develops when
(genital)
negative experiences at home, at school, or with peers
lead to feelings of incompetence.
Adolescence
Identity vs.
The adolescent tries to answer the question, who am I,
role confusion
and what is my place in society? By exploring values and
(genital)
vocational goals, the young person forms a personal
identity. The negative outcome is confusion about
future adult roles.
Early adulthood Young adults work on establishing intimate ties to
Intimacy vs.
isolation
others. Because of earlier disappointments, some
individuals cannot form close relationships and remain
isolated.
Generativity means giving to the next generation
through child rearing, caring for others, or productive
work. The person who fails in these ways feels an
absence of meaningful accomplishment.
Late adulthood Elders reflect on the kind of person they have been.
Ego integrity
vs. despair
Integrity results from feeling that life was worth living
as it happened. Those who are dissatisfied with their
lives fear death.
Source: Adapted from Berk (2014, p. 16)
Self-reflection
Look back over your life in the context of these stages. Can you relate to the challenges noted
in the above table?
24
Section 1: Introduction to counselling
3. Piaget’s Stages of Cognitive Development
Through observations of his own children’s growth, Jean Piaget proposed that children go
through several stages of learning in order to develop how to think (Zastrow & Kirst-Ashman,
2013). Thinking becomes more complex and complicated as the person gets older (Zastrow
& Kirst-Ashman, 2013). The table on the following page outlines these stages.
Piaget’s Stages of Cognitive Development
Stage
Period of
Development
Sensorimotor
Description
Birth-2 years
Infants “think” by acting on the world with their eyes,
ears, hands, and mouth. As a result, they invent ways of
solving simple problems, such as pulling a lever to hear
the sound of a music box, finding hidden toys, and
putting them in and taking them out of containers.
Preoperational 2-7 years
Preschool children use symbols to represent their earlier
sensorimotor discoveries. Development of language and
make-believe play takes place. However, thinking lacks
the logic of the two remaining stages.
7-11 years
Concrete
Children’s reasoning becomes logical. School age
operational
children understand that a certain amount of lemonade
or play dough remains the same even after its
appearance changes. They also organise objects into
hierarchies of classes and subclasses. However, thinking
falls short of adult intelligence. It is not yet abstract
Formal
11 years
The capacity for abstract, systematic thinking enables
operation
onwards
adolescents when faced with a problem, to start with a
hypothesis, deduce testable inferences, and isolate and
combine variables to see which inferences are
confirmed. Adolescents can also evaluate the logic of
verbal statements without referring to real-world
circumstances.
Source: Adapted from Berk (2014, p. 19)
Note: You will learn more about these theories of development in Study Guide 4 – Personality
and Development Theories.
Summary
This section of the Study Guide introduced you to the counselling profession. It provided you
with an overview of the evolution of counselling and its current place within the helping
professions. You were also introduced to some of the major counselling theories that you will
learn about later in the course.
References
Barkway, P. (2013). Psychology for health professionals (2nd ed.). Chatswood, NSW: Elsevier.
Berk, L. (2014). Development through the lifespan (6th ed.). New York, NY: Pearson.
Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Belmont, CA:
Brooks/Cole.
25
Study Guide 1: Counselling and the Counselling Process
Hough, M. (2014). Counselling skills and theory (4th ed.). London, UK: Hodder Education.
Jones-Smith, E. (2012). Theories of counseling and psychotherapy: An integrative approach. Thousand
Oaks, CA: Sage.
Kottler, J. A., & Shepard, D. S. (2015). Introduction to counseling: Voices from the field (8th ed.).
Stamford, CT: Cengage Learning.
McLeod, J. (2013). An introduction to counselling (5th ed.). London, UK: Open University Press.
Milne, A. (2010). Understand counselling: Teach yourself. London, UK: Hodder Education.
Myfuture (2013). Retrieved from http://www.myfuture.edu.au/
Nelson-Jones, R. (2014). Practical counselling and helping skills: Texts and activities for the lifeskills
counselling model (6th ed.). Dorchester, UK: Sage Publications.
Nevid, J. S. (2013). Psychology: Concepts and applications (4th ed.). Belmont, CA: Wadsworth.
Pennington, A. (2013). The student guide to counselling and psychotherapy approaches. London, UK:
Sage.
Wedding, D., & Corsini, R. J. (2014). Current psychotherapies (10th ed.). Belmont, CA:
Brooks/Cole, Cengage Learning.
Zastrow, C. H., & Kirst-Ashman, K. K. (2013). Understanding human behavior and the social
environment (9th ed.). Belmont, CA: Brooks/Cole.
Assessment activities
Assessment activities relevant to this section of the Study Guide are contained in Section 1
of your Assessment Book.
26
Section 2
USING A STRUCTURED
COUNSELLING PROCESS
27
Study Guide 1: Counselling and the counselling process
Using a Structured Counselling Process
About this Section:
In this section you will learn to:
 Work within a counselling framework
 Assist clients in clarifying their aims and requirements
 Develop and follow a structured approach to counselling based upon the client’s needs
and expectations
 Enable clients to explore possible courses of action
 Use problem solving steps
 Enable clients to understand the nature of the counselling service on offer, and clarify
their expectations and commitment to the counselling relationship
 Contract appropriate to context to address disclosure and organisation/service
requirements
Supporting materials:
The following materials supplement the information provided in this section:
1. Reading B
2. Reading C
This section of the Study Guide will introduce you to the counselling process. The counselling
process includes everything from the moment the client initiates contact with a counselling
service to the termination of the service. This can occur over a number of days, weeks, months,
or even years, depending upon the client’s needs. The purpose of this section of the Study
Guide is to help you to develop a basic understanding of what counselling involves and how
counsellors may work with clients to meet their goals. As you will have noticed while reading
about the different counselling approaches in the previous section of this Study Guide, there
is no one set way in which to conduct counselling. As such, it is important for counsellors to
take the time to explore with the client how counselling will proceed in each individual case.
The purpose of structuring
“Cormier et al. (2013) observe that ‘structuring’ refers to an interactional process between
counsellors and clients in which they arrive at similar perceptions of the role of the counsellor,
an understanding of what occurs in counselling, and an agreement on which outcome goals
will be achieved. Structuring occurs throughout counselling, and even prior to counselling –
for example, through the publicity, image and reputation of counsellors and counselling
agencies.”
(Nelson-Jones, 2014, p.130)
It is important to structure the counselling process from the very first session. As a counsellor,
this involves talking with the client and explaining your approach to counselling, the role of
both the client and counsellor in your approach, how counselling would proceed, the client’s
goals for counselling, what strategies or interventions you might use, the legal and ethical limits
28
Section 2: Using a structured counselling process
of confidentiality, and more practical concerns such as the costs involved in sessions and how
payment must be made. As Nelson-Jones (2014), outlines, structuring counselling can help to:

Reduce anxiety by clarifying the role of the counsellor and client

Explain the purpose of the current and subsequent sessions

Establish the expectancy that clients will work on problems in addition to talking about
them

Establish the possibility of change for the client

Communicate the limitations of the counselling relationship
Developing a structured plan for counselling can also help to guide the process so that clients
move through a set of distinct phases and reach a desired outcome. There are many different
ways in which a plan for counselling can be developed, and thus, as a counsellor you may be
asked to develop a range of possible interventions. In most cases, a counsellor will have a
particular or preferred structure in mind when they meet with a new client. However, as
counselling is a collaborative or interactional process, it is important that counsellors discuss
the plan with the client and give them the opportunity to voice their opinions and concerns.
Structured plans or frameworks are helpful for enabling both the client and counsellor to stay
on track and for empowering the client to be a more active participant in achieving their goals.
Self-reflection
Imagine that you are a client who is entering a counselling session for the very first time. How
would you feel if you knew very little about counselling and was unsure of what to expect?
How do you think you would feel after the counsellor engaged in a structuring conversation
with you?
The basic counselling structure
While counsellors from different theoretical orientations will have different approaches to the
change process, most forms of counselling will follow the same basic structure that includes a
preparatory, beginning, middle, and ending phase.
“The assumption is made that, irrespective of theoretical orientation, it is possible to
conceptualize the therapeutic process in terms of a framework of broadly defined phases or
stages. Each phase is characterized by particular process goals or tasks that need to be achieved
as a prerequisite of moving forward to the next phase (Beitman, 1990; Egan, 2010; McLeod,
2003). As a structural overview of the developmental process, the framework provides
therapists with a sense of grounding and direction. But it is only a cognitive map and as such
cannot reflect the actual experience or dynamics of a process that seldom, if ever, follows a
straightforward linear progression through discrete and clearly defined phases. As the
relationship between therapist and client develops, new issues may emerge, goals are evaluated
and often redefined, and earlier phase-related tasks may be revisited and worked on more
deeply. It is a fluid, multidimensional and complex process.”
(Horton, 2012, p. 122)
Self-reflection
What benefits do you think there may be in the explicit structuring of the counselling process?
What limitations do you think there may be in the explicit structuring of the counselling
process?
29
Reading B
Study Guide 1: Counselling and the counselling process
The four basic phases that counselling progresses through are outlined in the following table.
The four phases of counselling
Phase
Goals/tasks of the phase
Preparatory Phase
 Revision of prior knowledge of the client (such as a referral
letter or report).
 Introductory leaflet given to the client.
 The first telephone call between counsellor and client.
 Letter of appointment.
Beginning Phase
 Build the relationship, establish rapport and an effective
working alliance, clarify boundaries, conditions and the client’s
role, and work towards developing mutual aims about the work
of therapy.
 Facilitate client self-disclosure; identify the client’s presenting
problem through understanding the client’s worldview and
experiences, exploring antecedents, precipitating events,
social/cultural context and assessment of client strengths and
resources. The therapist may begin to develop a tentative
assessment of the nature, origins and ramifications of the
client’s problem(s) in a way that suggests a possible target for
change. In some psychodynamic work the early fostering of a
positive transference might be a key task.
 Negotiate therapeutic and business contracts, and monitor and
review progress.
Middle Phase
 Typically the longest phase in counselling; dependent upon the
therapist’s theoretical orientation and how they explain the
origin and maintenance of psychological problems and the
principles of change.
 Conflicts and problems are more clearly defined and worked
through.
 Therapist is concerned with facilitating learning and change.
 Process goals may involve searching for patterns and key
themes in the client’s experiences and behaviours, affirming
and, where possible and appropriate, using the client’s strengths
and ways of coping, working towards new perspectives, deeper
self-awareness or understanding and learning different ways of
thinking, feeling, and/or behaving.
 May contain regular review sessions
Ending Phase
 Seek resolution of the client’s issues around ending
 Explore ways of consolidating learning and change through
helping clients to apply and assimilate change into new ways of
being or living and through identifying obstacles and ways of
sustaining and expanding change.
 Evaluating the outcomes of therapy and the effectiveness (or
otherwise) of the therapeutic process and relationship.
Source: Adapted from Horton (2012, pp. 122-127)
For a more detailed description of these phases, please see Reading B. As the extract on the
previous page illustrates, these stages are not set in stone and may change depending upon the
Reading B
30
Section 2: Using a structured counselling process
needs of your client. Therefore, it is important that as a counsellor you remain flexible, patient,
and willing to adapt the structure of counselling in accordance with the client’s needs. It is also
important to note that while you may have a preferred method and structure in mind, you will
ultimately be guided by the organisation that you work for. Many organisations have preferred
methods and you may be limited by the kinds of services they are equipped to provide. For
example, while you may prefer to spend twenty sessions with a client, your organisation may
be time limited and only allow six sessions. It is good practice to inform the client of all of
these factors before you begin in order to clarify their expectations and understanding of the
counselling process and the services offered by your organisation.
Clarifying the client’s understanding and expectations
Clients may come to counselling with very little idea of what counselling involves or what a
particular service offers. Therefore, it is important that counsellors explain to clients during
the initial session what their individual approach is and the nature of the counselling service
on offer, including any limitations. If the client has a specific need that the counsellor (or their
agency/organisation) cannot help with, or if the client has a specific problem that the
counsellor’s individual approach may not be suitable for, then referral can be offered with
minimal wasted time for both the client and counsellor (Ivey, Ivey & Zalaquett, 2014). It is
important for counsellors to ensure that clients have an understanding of what resources and
services the counselling relationship can offer before counselling begins. For example, a client
who assumes that a counsellor can help them find accommodation or receive government
assistance should be informed as soon as possible if this is not part of the service. Counsellors
need to ensure that the client understands what the counselling service can and cannot offer
from the outset.
Similarly, counsellors should explain what models of counselling that they and their
agency/organisation offer. A client may have worked with other counsellors or seen an
example of counselling and assume all counsellors work in the same way. For example, a client
may like the idea of a particular kind of counselling, such as cognitive behavioural therapy, and
want to work in this way. However, if a counsellor and their agency/organisation only work
from a person-centred approach, then the counsellor would need to explain this method to
the client so that they have an understanding of what is involved and can decide whether they
would be happy with this service. If the client prefers another counselling approach or the
counsellor feels that the current service is not appropriate for the client’s particular needs, the
counsellor should offer to refer the client to a more appropriate counsellor/service. Referral
will be discussed in Section 4 of this Study Guide.
Contracts
Counselling contracts can be used as a way of formalising the plan and ensuring that both
client and counsellor agree on what the counselling process will entail (including the type of
treatment and the amount and frequency of sessions) and how outcomes will be achieved.
Contracting can also be a way to help the client to develop realistic expectations of the
counselling process and allow them to understand what is expected of them (i.e., attendance
at appointments, payment, etc.). Contracts should be written within the context of the client’s
needs, your abilities, and the organisation you are working for. You will need to make clear
what services you/your organisation offers, including the limits to the service.
“A counseling contract may include an agreement regarding issues such as those related to
confidentiality, general and specific goals, the counseling process, the counseling methods to
be used by the counselor, and issues to be discussed. At the contracting stage we like to make
it clear that the client’s wishes will be respected with regard to what issues will and will not be
31
Study Guide 1: Counselling and the counselling process
discussed. This is very important for some clients who may fear that they will be pressured in
subtle ways to discuss issues which they do not wish to explore.
Sometimes a contract will involve an agreement to attend counseling sessions at regular
intervals; for example weekly or fortnightly for a particular number of sessions, with a review
of the counselling process occurring at set times.”
(Geldard & Geldard, 2012, p. 15)
As the above extract illustrates, the counsellor should also discuss confidentiality and
disclosure issues with the client as part of the counselling contract. Clients should be made
aware of the circumstances under which confidentiality may be broken. Generally, these
circumstances include:




If the client discloses that they may harm themselves;
If the client discloses that they may harm others, or;
If the client’s file is subpoenaed by a court of law; or
If the client has provided written permission for you to do so.
A counselling contract may be a verbal or written agreement between the counsellor and the
client (although written agreements are preferred for record-keeping purposes). The contract
helps to establish the purpose of the service and outlines the methods the counsellor or agency
use as well as the available resources of the agency.
An example of a counselling contract is included below:
COUNSELLING CONTRACT
XYZ Counselling Service
Counselling approach
I believe that my clients have the desire and the capacity to grow towards fulfilling their true
potential, and that they are the experts on their own lives. Therefore, I will not give you advice
or offer solutions, but will work with you to help you understand yourself more fully and to
find your own inner resources. With greater self-awareness and trust in yourself, I hope that
you will be able to make constructive changes, leading to a more satisfying and meaningful
life.
Confidentiality
Everything you share with me in the course of our work together will be treated as highly
confidential. However, there are a few circumstances in which I may be required to break
confidentiality:



If I consider you to be at risk of seriously harming yourself or someone else
If your counselling records have been requested by a court of law
If another party or agency has requested your information, and you have agreed and
provided your written consent to this.
Sessions
Our initial contract will run for six weeks, after which we will review the counselling process
and negotiate further sessions as appropriate. Normally we will meet on a weekly basis at a
regular time.
32
Section 2: Using a structured counselling process
Payments/cancellations
Each 1-hour session costs $120. Payment will be taken at the beginning of each session and
may be made by cash, EFTPOS, credit card, or cheque. Late cancellation fees are payable as
follows: 0-24 hours’ notice – full session fee payable. 24-48 hours’ notice – 50% of session fee
is payable.
Record keeping
I will take notes during or after each session to help me keep track of our progress together.
These notes will be stored in a private and secure location and may be viewed by you if you
so wish. Your counselling records will be kept by the service for a period of seven (7) years
from the date of your last contact with the service.
Email/telephone contact
Email or telephone contact will be limited to practical arrangements only. I will not enter into
telephone or email counselling except by prior arrangement.
If you are faced with an emergency in between sessions, please contact the appropriate
emergency service (see overleaf). In a life threatening situation, call 000 without delay.
Ending counselling
Normally, the end of counselling would be by mutual prior agreement. However, you have
the right to end your counselling at any time. I would appreciate you letting me know if you
decide not to return to counselling, giving at least 48 hours notice. If at any time I feel that
our counselling is no longer appropriate for you, I will discuss this with you and may suggest
discontinuation or a referral to a more appropriate service.
Client signature: _________________________ Date: _______
Counsellor signature: __________________________ Date: ________
Source: Adapted from Crane (2013)
Supporting clients in decision-making processes
“An important set of counselling tasks centres on the process of making choices. There are
many situations in which people seek help, and want to talk things through with someone who
is independent of their immediate situation, because they cannot decide what to do.
Depending on the circumstances, clients may view this kind of task in a variety of different
terms: choosing, solving a problem, reviewing options, devising a plan, or making a decision.
Each of these tasks involves a process of collecting, appraising, organising and analysing
information, leading to a conclusion to which the person makes an emotional and behavioural
commitment.”
(McLeod & McLeod, 2011, p. 222)
While there are a number of issues that may prompt and individual to seek counselling, a very
common cause is that clients feel that they need help making an important decision in their
lives. As such, counsellors commonly assist clients with decision-making processes. However,
that does not mean that counsellors make decisions for their clients. Indeed, counsellors
should never make decisions on behalf of their clients, push their own agenda, or provide
advice. Instead, counsellors assist clients in the decision-making process by supporting the
client through each stage of the process so that the client fully understands their problem,
develops achievable goals, cultivates realistic strategies to obtain these goals, and takes practical
33
Study Guide 1: Counselling and the counselling process
steps to complete their goal strategies. Essentially, supporting clients in the decision-making
process involves the following steps:

Encouraging clients to explore their problem. This requires the counsellor to help the
client feel comfortable enough to open up and discuss all aspects of their problem. The
counsellor uses basic counselling techniques to help the client feel at ease. They then use
effective questioning to help the client explore all facets of their problem.

Support clients to identify their goals. This involves encouraging the client to not only
come to an understanding of their current situation, but to also consider how exactly they
would like to improve their situation. The counsellor should encourage the client to think
about their overall goals and how these would fit in with their current circumstances. It
is important that the counsellor supports the client in identifying goals that are specific,
realistic, and achievable. If the client’s goals are too vague, or relate to others instead of
themselves, the counsellor will help the client to modify their goals so that they are
achievable for the client.

Support clients to identify how goals can be achieved. Once the client has decided
upon realistic goals, it is important to help them to identify how each of these goals might
be achieved. One commonly used technique at this stage is to brainstorm with the client
all potential courses of action for achieving their identified goals. It is important to
consider the specific steps that would need to be taken to achieve goals. Sometimes the
client will be unsure of how to go about achieving their goals so the counsellor may
suggest strategies and potential courses or action, however, it is important that counsellor
suggestions be treated only as suggestions and not imposed upon the client.

Evaluate potential courses of action. Once the brainstorming processes has finished,
the client will have to choose a particular course of action. One effective technique to
assist clients in this step is to evaluate each of the potential courses of action together.
This involves the following steps:
 Summarising each of the possible courses of action
 Assisting the client to assess the advantages and disadvantages of each
 Helping the client assess the overall appropriateness of each possible course of
action based on their particular circumstances
 Assisting the client to thoroughly consider the possible consequences of each
course of action
 Helping the client to rank each potential course of action and decide upon the most
appropriate one

Selecting a particular course of action. At the end of the process it is important that
the client make a firm decision on a particular course of action. Once this is done the
counsellor should confirm that the client understands exactly how they will go about
implementing this course of action as well as help the client develop contingency plans
for each step.

Document it. The final step is to document the client’s decision. In some cases the
selected course of action may involve the counsellor or their organisation providing
additional services or referring the client for additional support. In these cases the
counsellor must also ensure that they complete case planning and referral documentation
in line with their organisational requirements.
34
Section 2: Using a structured counselling process
Self reflection
Consider the last significant decision you had to make. Can you remember the process that
you went through to make that decision? Do you recall going through any (or all) of the
aforementioned steps? Are there any other steps that you took that you think would be useful
when working through decision-making with clients?
Essentially, counsellors aim to empower the client to complete these decision-making steps in
order to explore their problem, identify their goal, generate ideas for how this goal can be
achieved, evaluate the alternatives, choose the most appropriate course of action, and
implement it. Reading C provides an example of how such a decision-making conversation
may take place within a counselling session.
Summary
This section of the Study Guide discussed the use of a structured approach to counselling.
You were introduced to the basic counselling framework and learned about the importance of
discussing the counselling process with the client in order to clarify their understanding and
expectations from the very beginning of the counselling relationship. You also learned about
how counsellors can help clients with decision-making processes. In the next section, you will
learn more about the counselling relationship.
References
Crane, J. (2013). Counselling agreement. Retrieved from http://www.counsellingbristol.co.uk/
wp-content/uploads/2013/01/Counselling_Contract1.pdf
Geldard, K. & Geldard, D. (2012). Personal counseling skills: An integrative approach. Springfield,
IL: Charles C Thomas.
Horton, I. (2012). Structuring work with clients. In C. Feltham & I. Horton (Eds.), The Sage
handbook of counselling and psychotherapy (3rd ed.; pp. 122-128). London, UK: Sage.
Ivey, A. E., Ivey, M. B.,& Zalaquett, C. P. (2014). Intentional interviewing and counseling: Facilitating
client development in a multicultural society (8th ed.). Belmont, CA: Brooks/Cole.
Nelson-Jones, R. (2014). Practical counselling and helping skills (6th ed.). London, UK: Sage.
McLeod, J., & McLeod, J. (2011). Counselling skills: A practical guide for counsellors and helping
professionals (2nd ed.). Berkshire, UK: Open University Press.
Assessment activities
Assessment activities relevant to this section are contained in Section 2 of your Assessment
Book
35
Reading C
Study Guide 1: Counselling and the counselling process
36
Section 3
THE HELPING
RELATIONSHIP
37
Study Guide 1: Counselling and the counselling process
The Helping Relationship
About this Section:
In this section you will learn how to:
− Give attention to the counselling relationship, including:
- How to encourage clients to feel at ease and express themselves
- How to build empathy and rapport
- Active listening skills
- How to respectfully respond
- Acknowledging and respecting client’s immediate concerns and needs
- Affirming the significance of what the client says
- How to challenge clients
− Become aware of obstacles to the counselling process, including identifying and
exploring client anxieties about the counselling process
− Enable clients to understand the nature of the counselling services on offer by clarifying,
confirming, and modifying their expectations of the counselling services
Supporting materials:
The following materials supplement the information provided in this section:
1. Reading D
2. Reading E
Arguably the most important aspect within the counselling process is the relationship between
the counsellor and client.
“Clients come to counselling in pain, with problems, with decisions, in crisis and in need of
support. They need to relate to or become connected to counsellors as a means of working on
their concerns. The counselling relationship is defined here as the quality and strength of the
human connection that counsellors and clients share.”
(Nelson-Jones, 2014, p. 77)
The relationship between counsellor and client lies at the very heart of the counselling process.
While many people assume that counsellors are innately skilled at connecting with clients,
there are actually many skills and techniques that counsellors must learn to utilise in order to
assist them in developing an effective therapeutic alliance. You will learn more about these
skills and how to apply them throughout each of the units of this course. This section merely
provides a brief introduction to some of the most important basic counselling skills.
Self-reflection
Take a moment to reflect on what you believe constitutes a good helping relationship. What
skills or attributes do you think an effective counsellor must possess? Why?
Building rapport
One of the most important skills for a counsellor to possess is the ability to build rapport.
Building rapport involves establishing a connection with a client so that they feel at ease and
38
Section 3: The helping relationship
comfortable enough to express themselves and share their story. Obviously every client is
different and so the path to developing rapport is not always the same; however, there are
some key techniques that a counsellor can use to improve the efficiency and effectiveness of
rapport building. These include:

Active listening. Counsellors must show their client that they are actively paying
attention to what they are saying or expressing. Active listening requires the use of
communication skills such as:
− Listening carefully to what the client is saying, both verbally and through their
body language.
− The use of encouragers and minimal reinforcers (such as nodding or saying
“uh-huh”) to encourage the client to continue telling their story.
− Paraphrasing and summarising. This involves the counsellor repeating back
or summarising the client’s story (using key words) in order to demonstrate
that they have listened and understood what the client is saying.
− Reflection of feeling and content. This involves the counsellor considering
the thoughts and feelings that the client has expressed and reflecting those
back to the client.
− Checking the accuracy of the counsellor’s understanding through use of
check-ins (i.e., questions such as “is that right?” after a paraphrase, summary,
or reflection).

Mirroring. This involves understanding and copying the client’s own style of
communication and posture. This can help clients to feel comfortable with the
counsellor and the counselling process (Nelson-Jones, 2014).

Empathic responding. Counsellors must take care to respond to both the content
of what the client is saying, and the emotions they are experiencing or expressing (Ivey,
Ivey, & Zalaquett, 2014).

Demonstrating acceptance and respect. It is vital for counsellors to listen and
respond without judgement.

Self-disclosure. Counsellor self-disclosure can help build rapport by increasing the
counsellor’s authenticity, building a sense of trust between client and counsellor, and
promoting feelings of universality (Cormier, Nurius & Osborn, 2013). However, selfdisclosure must always be used with extreme care. If it is done for the wrong reasons,
used excessively, or used too early in the counselling relationship, it may do more harm
than good.
Self-reflection
Take a moment to reflect upon your current skills in developing rapport with others. Do you
find it easy to converse with and empathise with others? What skills do you think you need to
develop?
Microskills
Microskills are vital for building rapport with clients and usually form the basis of an effective
counselling relationship. The table on the next two pages provides a brief overview of the
main microskills that are used in counselling.
39
Reading D
Study Guide 1: Counselling and the counselling process
Microskill
Description of Skill
Anticipated Impact on Client
Attending
Behaviour
“Support
your
client
with
individually
and
culturally
appropriate
verbal
following,
visuals, vocal quality and body
language” (p. 65).
“Clients will talk more freely and
respond openly, particularly about
topics to which attention is given.
Depending on the individual client
and culture, anticipate fewer
breaks in eye contact, a smoother
vocal tone, a more complete story
(with fewer topic jumps), and a
more comfortable body language”
(p. 65).
Empathy
“Experiencing the client’s world
and story as if you were the client;
understanding his or her key issues
and saying them back accurately,
without adding your own thoughts,
feelings, or meanings. This requires
attending and observation skills plus
using the important key words of
the client, but distilling and
shortening the main ideas” (p. 73).
“Clients will feel understood and
engage in more depth in exploring
their issues. Empathy is best
assessed by the client’s reaction to
a statement and his or her ability to
continue the discussion in more
depth and, eventually, with better
self-understanding” (p. 73).
Observation
“Observe your own and the client’s
verbal and nonverbal behaviour.
Anticipate
individual
and
multicultural
differences
in
nonverbal and verbal behaviour.
Carefully and selectively feed back
some here-and-now observations to
the client as topics for exploration”
(p. 92).
“Observations provide specific
data validating or invalidating what
is happening in the session. Also,
they provide guidance for the use
of various microskills and
strategies. The smoothly flowing
session will often demonstrate
movement
symmetry
or
complementarity.
Movement
dissynchrony provides a clear cue
that you are not “in tune” with the
client” (p. 92).
Questioning
“Begin open questions with the
often useful who, what, when, where,
and why. Could, can, or would
questions are considered open but
have the additional advantage of
being somewhat closed, thus giving
more power to the client, who can
more easily say that he or she
doesn’t want to respond.
“Clients will give more detail and
talk more in response to open
questions. Could, would, and can
questions are often the most open
of all, because they give clients the
choice to respond briefly (“No, I
can’t”) or, much more likely,
explore their issues in an open
fashion.
Closed questions may start with do, Closed questions may provide
is, or are” (p. 119)
specific information but may close
off client talk” (p. 119).
40
Section 3: The helping relationship
Encouraging
“Encouraging (using encouragers
and restatements):
Give short responses that help
clients keep talking. They may be
verbal statements (repeating key
words and short statements) or
nonverbal actions (head nods and
smiling)” (p. 140).
“Clients elaborate on the topic,
particularly when encouragers and
restatements are used in a
questioning tone of voice” (p.
140).
Paraphrasing
“Paraphrasing (also known as
reflection of content):
Shorten, clarify the essence of what
has just been said, but be sure to use
the client’s main words when you
paraphrase. Paraphrases are often
fed back to the client in a
questioning tone of voice” (p. 140).
“Clients will feel heard. They tend
to give more detail without
repeating the exact same story. If a
paraphrase is inaccurate, the client
has an opportunity to correct the
counsellor” (p. 140).
Summarising
“Summarise client comments and
integrate thoughts, emotions, and
behaviours. This technique is similar
to paraphrase but used over a longer
time span. Important in the
summary is that you seek to find
strengths and resources that support
the client” (p. 140).
“Clients will feel heard and often
learn how the many parts of their
stories are integrated. The
summary tends to facilitate a more
centred and focused discussion.
The summary also provides a
more coherent transition from one
topic to the next or a way to begin
or end a full session” (p. 140).
Reflection of
Feelings
“Identify the key emotions of a “Clients will experience and
client and feed them back to clarify understand their emotional state
affective experience. With some more fully and talk in more depth
clients, the brief acknowledgement about emotions and feelings. They
of a feeling may be more may correct the counsellor’s
appropriate. Often combined with reflection with a more adequate
paraphrasing and summarizing” (p. descriptor” (p. 161).
161).
Source: Adapted from the indicated pages of Ivey, Ivey & Zalaquett (2014)
Please note: You will learn more about these skills and how to apply them in the next few
Study Guides of this Diploma. At this stage, it is simply important for you to remember that
an effective, positive relationship between counsellor and client is central to the success of
counselling. The counsellor’s ability to apply counselling microskills to draw out, listen to, and
fully understand the client’s concerns, as well as the ability to convey this understanding to the
client, are central to building an effective counselling relationship (Nelson-Jones, 2014).
Self-reflection
Can you think of a time in which you confided in or sought advice from someone and felt that
they were really listening to you? In what ways did they show you that they were listening? Did
they use any of the basic counselling microskills or techniques that we have discussed?
41
Study Guide 1: Counselling and the counselling process
Obstacles to the counselling process
Despite your best efforts and use of microskills, you may find yourself unable to build rapport
with some clients. This can be for a number of reasons, including the presence of obstacles to
the counselling process. Being aware of any potential obstacles that could disrupt, or even
completely stop, the counselling process or the development of rapport will make it easier to
deal with if and when they arise. We will now discuss some of the most common obstacles to
the counselling process and development of rapport.
Client anxieties
Most clients enter counselling while in a heightened state of emotion that can make the process
of developing rapport and building an effective counselling relationship quite difficult. New
clients are often anxious, upset, or in turmoil. Some new clients may be content to express
these emotions to their counsellor; however, many will have difficulty with opening up to a
complete stranger and sharing stories and concerns that they may not have even shared with
their family and closest friends.
In the early stages of the working relationship, one of the primary goals should be to establish
trust and a shared understanding of what the counselling process will entail. This can be done
by using the usual rapport building strategies; however, you may find this process will take
longer for some clients than for others. You should also explain to the client what they can
expect from the counselling sessions in general, as well as from you as the counsellor, and
make sure to answer any questions they have about the process. Once the client’s anxiety levels
about the process have been reduced, you can start building a truly effective helping
relationship.
Differences in background, culture, and values
Another essential part of the counselling relationship is the counsellor’s ability to understand
clients in the social, cultural, and personal contexts in which they live. Disruptions to the
counselling process may occur if the counsellor is unable to do this. The following extract
outlines just some of the many areas of diversity to consider when practicing counselling.
RESPECTFUL Counseling and Psychotherapy
“The RESPECTFUL model (D’Andrea & Daniels, 2001; Ivey, D’Andrea, & Ivey, 2012) makes
it clear that multiculturalism refers to far more than race and ethnicity. As you review the list
below, first identify your own multicultural background. Then examine your beliefs and
attitudes toward those who are culturally similar to and different from you on each issue. How
prepared are you to work with clients who are culturally different from you? And all clients
are culturally different in some way.”
R
E
S
P
E
C
Religion/spirituality. What is your religious and spiritual orientation? How does this
affect your thoughts, feelings, and behaviors as a counselor?
Economic/class background. How will you work with those whose financial and social
background differs from yours?
Sexual orientation and/or gender identity. How effective will you be with those whose
gender and/or sexual orientation differs from yours?
Personal style and education. How will your personal style and educational level affect
your practice?
Ethnic/racial identity. The color of a person’s skin is one of the first things we notice.
What is your reaction to different races and ethnicities?
Chronological/lifespan challenges. Children, adolescents, young adults, mature adults,
and older people all face different issues and challenges. Where are you in the
42
Section 3: The helping relationship
T
F
U
L
developmental lifespan?
Trauma. It is estimated that 90% or more of all people experience serious trauma in
their lives. Trauma underlies the issues faced by many of your clients. War, flood, rape,
and assault are powerful examples, but a serious accident, divorce, loss of a parent, or
being raised in an alcoholic family are more common sources of trauma. The constant
repetition of racist, sexist, or heterosexist actions and comments can also be traumatic.
What is your experience with life trauma? We now recognize it as a “normal” part of
being alive for most of us.
Family background. We learn culture in our families. The old model of two parents
with two children is challenged by the reality of single parents, gay families, and varying
family structures. How has your life experience been influenced by your family history
(both your immediate family and your intergenerational history)?
Unique physical characteristics. Become aware of disabilities, special challenges, and
false cultural standards of beauty. In addition, physical health is a key part of mental
health. Exercise, nutrition, yoga, and meditation are not traditionally included as part
of formal helping theory and practice, but research and clinical experience have now
changed our view and these are an essential part of modern counseling. How well do
you understand the importance of the body in counseling and psychotherapy, and how
will you work with others different from you in their physical characteristics and
interests?
Location of residence and language differences. Whether in the United States, Great
Britain, Turkey, Korea, or Australia, there are marked differences between the south
and north, east and west, urban and rural. Moreover, many of you reading this book,
and certainly many of your clients, will come from a wide variety of nations. The small
town of Amherst, Massachusetts, has 23 different languages represented in their
schools. Remember that a person who is bilingual is advantaged and more skilled, not
disadvantaged. What languages do you know, and what is your attitude towards those
who use a different language from you?”
(Ivey, Ivey & Zalaquett, 2014, pp. 18-19)
Self-reflection
Complete the exercise described in the extract above. Thinking about the different dimensions
of the RESPECTFUL model can be a very useful exercise for helping new counsellors to
understand themselves as a cultural being.
Consider what you have learned about yourself from this exercise. Also, consider what steps
you could take to increase your awareness and ability to work with clients who are different to
yourself.
One way to ensure that differing cultures, backgrounds, and values do not disrupt the
counselling process is to make sure you manage your own values. Counsellors must ensure
that they understand their own reactions and motivations within the counselling relationship.
Counselling is not about pushing a person in a certain direction, judging a client or giving them
advice. Counsellors must show respect for the diversity of the client by not imposing their
own values, attitudes, beliefs, and behaviours upon them.
Self-awareness is a vital skill for counsellors to possess. Throughout your development as a
counsellor you must ensure that you continually assess your personal strengths and limitations
in this regard. Developing the competence to work with clients from a diverse range of
backgrounds involves ongoing personal and professional development. Please note that issues
43
Reading E
Study Guide 1: Counselling and the counselling process
of diversity in counselling are explored in more detail later in the course (Study Guide 17 –
Working with Diversity).
Clients with insufficient self-awareness
Often clients come to counselling without having an accurate understanding of their own
thoughts, emotions and behaviours. For example, some clients:

Distance themselves from their thoughts or emotions by speaking in abstract or
general terms rather than expressing themselves directly.

Demonstrate inconsistencies in their behaviours and in what they say they want.

Have distortions in their thoughts, such as “I need to do something perfectly or there
is no point doing it at all” or “I’m a failure, I never do anything right”.

Fail to see other opportunities or courses of action.
Such clients may have difficulty embracing the counselling process because they often
underestimate their ability to make positive changes in their own lives. Sometimes clients are
‘stuck’ in a particular pattern of behaviour and even though they work through strategies to
change those behaviours within counselling sessions, they may not implement these strategies
in their life outside the counselling environment.
One effective approach for a counsellor to assist such clients is to utilise the skill of welltimed challenging. Challenging is the process of acknowledging and reflecting client’s
discrepant, inconsistent, and mixed messages. For example, when dealing with a client who
has thought distortions (e.g., “I need to do something perfectly or there is no point doing it at
all” or “I’m a failure, I never do anything right”) the counsellor may ask “Where is the evidence
for that?” or may challenge the client’s existing perceptions by offering new perceptions or
ways of viewing problematic situations.
When challenging, it is important to start with an accurate reflection of the client’s previous
message (Ivey, Ivey & Zalaquett, 2014). This demonstrates that the counsellor has understood
the client and acknowledged their viewpoint. By taking these steps, the client is more likely to
be open to the content of the challenge. Care must also be taken with the strength and
frequency of challenges. It is important to ensure that the counselling environment remains a
safe, supportive, and therapeutic space by not over-doing it. You should only challenge a client
after a counselling relationship has been established, when you have the time and effort to
continue building the relationship, and when you know your own motivations for doing it.
Clients who are unsure of where to begin
Sometimes clients will come into counselling not knowing the main concern that they would
like to focus on. They may mention numerous concerns and it will be unclear which one takes
precedence. When clients have a number of concerns, the best thing to do is to summarise
and acknowledge them all and then ask the client to pick one to focus on.
Alternatively, some clients may spend the majority of the first session focusing on small issues
because they are too uncomfortable to talk about what is really bothering them. In such cases
it is important for the counsellor to develop rapport and help the client feel understood by
affirming everything that the client has said, no matter how small the problem may seem.
Acknowledging these concerns can help the client to feel free to talk about the more important
ones.
44
Section 3: The helping relationship
Demanding and unmotivated clients
A demanding client is one who may believe that the counsellor will provide answers to all of
their problems. They may come into counselling with unrealistic expectations about the
counselling process or their relationship with the counsellor. Some traits of demanding clients
include:








Telephoning frequently and expecting free and immediate counselling
Demanding more sessions than the counsellor believes is necessary
Demanding more time during sessions
Demanding that the counsellor socialise with them
Attempting to get the counsellor to take responsibility for their problems and/or life
Forcefully arguing their point of view
Expecting the counsellor to manipulate another person to have their needs met
Expecting the counsellor to provide them with solutions to their problems.
Beginner counsellors often find demanding clients quite difficult to work with. Some
techniques that you may use when dealing with such behaviours include:




Be assertive. It is important to be clear and firm with such clients.
Have an understanding of the reasons why these demands are being placed on you. By
considering the underlying reasons for demanding behaviour you will be better able to
effectively deal with it.
Confront the demand in an appropriate manner. Such behaviours should be discussed
within the counselling sessions and clarifications surrounding the role of the counsellor
and the boundaries of counselling should be made.
Understand and acknowledge your reactions to such behaviour. Some counsellors
possess the need to be ‘liked’ by or to ‘help’ all of their clients. This can often lead to
counsellors giving in to demanding behaviours. By understanding your internal
reaction to demanding behaviour you will be better able to keep professional
boundaries.
Conversely, a lack of commitment can also be a challenging problem in the counselling
process. A lack of motivation and commitment can be common in involuntary clients (for
example someone who has been referred to drug counselling as part of a criminal sentence or
a husband who has been forced by his wife to attend couple’s counselling in order to preserve
their marriage). Some typical characteristics of the uncommitted client include:




They may forget appointments
They may show indifference to the counsellor and the counselling process
They may not actively participate in the counselling process
They may not take responsibility for their own problems
Generally, counsellors are motivated to help their clients. As such, it can be a source of dismay
and frustration for a counsellor when their efforts are met with disengagement or resistance.
When this persists counsellors may find themselves feeling defensive, rejected and even angry.
While this is an understandable reaction, it is important for the counsellor to clearly identify
the reasons for this reaction and to develop strategies for dealing with it. Framing and reframing (in which the counsellor works with the client to shift the client’s point of view) are
good tactics to re-model the way the client perceives the counselling relationship. Creating
45
Study Guide 1: Counselling and the counselling process
goals and structuring can also motivate clients to engage in the helping relationship. The
creation of a counselling contract, as discussed in Section 2, can also help to clarify the
client’s expectations, inform them of their duties, and confirm their commitment to the
counselling process.
Summary
In this section, you learned about how to establish the helping relationship through use of
microskills and rapport building. You also learned about some of the obstacles to the
counselling process and helping relationship that might arise, such as differences in culture
and values, and demanding clients.
References
Cormier, S., Nurius, P. S., & Osborn, C. J. (2013). Interviewing and change strategies for helpers (7th
ed.). Belmont, CA: Brooks/Cole.
Ivey, A. E., Ivey, M. B.,& Zalaquett, C. P. (2014). Intentional interviewing and counseling: Facilitating
client development in a multicultural society (8th ed.). Belmont, CA: Brooks/Cole.
Nelson-Jones, R. (2014). Practical counselling and helping skills: Texts and activities for the lifeskills
counselling model (6th ed.). Dorchester, UK: Sage Publications.
Assessment activities
Assessment activities relevant to this section are contained in Section 3 of your Assessment
Book.
46
Section 4
COUNSELLOR
RESPONSIBILITES
47
Study Guide 1: Counselling and the counselling process
Counsellor Responsibilities
About this Section:
In this section you will learn to:
 Identify ethical responsibilities in providing counselling, including limits of
competence and responsibility and individual need for support and supervision
 Identify indicators of client issues requiring referral and report or refer appropriately,
in line with organisation requirements and protocols. Indicators may include
indications of physical or mental ill health
 Maintain documentation as required, including policy and principles to secure and
maintain confidentiality, and clearly explain these policies to the client
 Be aware of organisational role and responsibilities
Supporting materials:
The following materials supplement the information provided in this section:
1. Reading F
2. Reading G
3. You may also access and download the Australian Counselling Association’s Code of
Ethics and Practice from http://www.theaca.net.au/documents.php
Counsellors must always be mindful of meeting their client’s needs and ensuring that the
counselling relationship is appropriate for a helping relationship. This means making sure to
uphold all legal and ethical responsibilities and ensuring that their level of skill and knowledge
is suitable for each individual client. When a counsellor becomes aware that either they or the
organisation that they work for does not have the expertise to deal with a particular client’s
concerns, they should discuss appropriate referral with the client. In this section, you will learn
about how to confirm the appropriateness of the helping relationship by adhering to your
ethical responsibilities.
Supervision
Reading F
One of the most important responsibilities you will have as a counsellor is to access
appropriate professional supervision. Supervision is also a mandatory requirement for many
professional counselling organisations, including Australia’s largest registration body for
counsellors, the Australian Counselling Association (ACA).
“Supervision is: A formal arrangement for counsellors to discuss their work regularly with
someone who is experienced in counselling and supervision. The task is to work together to
ensure and develop the efficiency of the counsellor/client relationship. Professional
supervision is a process to maintain adequate standards of counselling and a method of
consultancy to widen the horizons of an experienced practitioner.
Counselling exposes counsellors to situations that impose a great demand on practitioners’
emotional and professional well-being. This demand can lead to becoming enmeshed and
over-involved leading to ineffective practices. A supervisor can be objective and help the
counsellor to grow and learn. The supervisor can ensure that the counsellor is meeting the
48
Section 4: Counsellor responsibilities
needs of their clients and keeping to ethical and professional standards. Supervisors will also
help counsellors relate practice to theory and visa versa. Supervisors are more likely to identify
potential mental health issues in the Supervisee before they become a problem.”
(Australian Counselling Association, 2013a, p. 4-5)
Supervision can be conducted in one-on-one, in a group setting, or with a peer. While
supervision is a requirement for all counsellors, no matter how many years they have been
practicing, it is particularly helpful for new counsellors to ensure the client is receiving an
appropriate service.
Counsellor responsibilities to clients
The process of counselling can put a client into a very vulnerable position. Because of this,
the counsellor must be aware of the responsibilities they have to the client and their well-being.
The ACA provides a consistent Code of Conduct and Practitioner Standards that can be used
to guide counsellors in their responsibilities. Their Code of Ethics and Practice outlines several
of the ethical responsibilities a counsellor must adhere to when working with clients. We will
discuss several of them here.
Confidentiality
Clients are entitled to receive a confidential service and be aware of the limits to that
confidentiality. The ACA Code of Ethics states:
“3.7 Management and Confidentiality
(a) Counsellors should ensure that records of the client’s identity are kept separately from
any case notes.
(b) Arrangements must be made for the safe disposal of client records, especially in the
event of the counsellor’s incapacity or death.
(c) Care must be taken to ensure that personally identifiable information is not transmitted
through overlapping networks of confidential relationships.
(d) When case material is used for case studies, reports or publications the clients
informed consent must be obtained wherever possible and their identity must be
effectively disguised.
(e) Any discussion of their counselling work with other professionals should be
purposeful and not trivializing.
(f) Counsellors must pay particular attention to protecting the identity of clients.”
(Australian Counselling Association, 2013b, p. 9)
Thus, in order to protect client’s personal information, both computerised and hard copy
records must be kept securely so they are only accessible by authorised personnel. However,
as a general rule, there are several circumstances in which confidentiality can be breached. This
includes situations when:




Your client discloses that they may harm themselves or another person; or
Your client discloses that they have committed a crime; or
Your client file is subpoenaed by a court of law; or
You have the client’s written permission to do so
These situations are known as ‘exceptional circumstances’. In regards to exceptional
circumstances, the ACA Code of Ethics states:
49
Reading G
Study Guide 1: Counselling and the counselling process
“3.6 Exceptional Circumstances
(a) Exceptional circumstances may arise which give the counsellor good grounds for
believing that serious harm may occur to the client or to other people. In such
circumstance the client's consent to change in the agreement about confidentiality
should be sought whenever possible unless there are also good grounds for believing
the client is no longer willing or able to take responsibility for his/her actions
Normally, the decision to break confidentiality should be discussed with the client and
should be made only after consultation with the counselling supervisor or if he/she is
not available, an experienced counsellor.
(b) Any disclosure of confidential information should be restricted to relevant
information, conveyed only to appropriate people and for appropriate reasons likely
to alleviate the exceptional circumstances. The ethical considerations include achieving
a balance between acting in the best interests of the client and the counsellor’s
responsibilities under the law and to the wider community.
(c) While counsellors hold different views about grounds for breaking confidentiality,
such as potential self-harm, suicide, and harm to others they must also consider those
put forward in this Code, as they too should imbue their practice. These views should
be communicated to both clients and significant others e.g. supervisor, agency, etc.”
(Australian Counselling Association, 2013b, p. 9)
Self-reflection
How easy or difficult do you believe it will be to uphold your client’s right to confidentiality?
How would you feel if your client told you that they were planning to hurt someone? What
actions do you believe you should take?
As a counsellor, it is your responsibility to promote your client’s understanding of these rights
and limitations by outlining the concept of confidentiality and its limits at the beginning of the
counselling relationship. Your client needs to be aware of what circumstances may warrant a
breach of confidentiality from you.
Professional boundaries
Boundaries between the counsellor and their client provide a consistent framework and
structure for their working relationship and the counselling process. Counselling is generally a
vulnerable experience for the client. They may not know what is going to happen or how the
counsellor is going to react to them. They will tell the counsellor their most intimate secrets,
while the counsellor may share almost nothing about themselves. This creates an imbalance
of power that the counsellor must remain sensitive to. By maintaining professional boundaries,
the counsellor can protect both themselves and the client from poor or unethical practice.
In regard to boundaries between counsellors and clients (and former clients), the ACA Code
of Ethics and Practice states:
“3.9 Boundaries
(d) With Clients
i.
Counsellors are responsible for setting and monitoring boundaries throughout
the counselling sessions and will make explicit to clients that counselling is a
formal and contracted relationship and nothing else.
ii.
The counselling relationship must not be concurrent with a supervisory,
training or other form of relationship (sexual or non-sexual).
50
Section 4: Counsellor responsibilities
(e) With Former Clients
i.
Counsellors remain accountable for relationships with former clients and must
exercise caution over entering into friendships, business relationships, training,
supervising and other relationships. Any changes in relationship must be
discussed in counselling supervision. The decision about any change(s) in
relationships with former clients should take into account whether the issues
and power dynamics presented during the counselling relationship have been
resolved. Section 3.9 (b) ii below is also of relevance here.
ii.
Counsellors are prohibited from sexual activity with all current and former
clients for a minimum of two years from cessation of counselling.”
(Australian Counselling Association, 2013b, p. 11)
Self-reflection
Sometimes clients may view their counsellors as friends and try to engage them in a concurrent
relationship by inviting them to birthday parties or buying them gifts. Take a moment to
consider what the appropriate action would be in cases like this.
Counsellor competence
It is vital that counsellors ensure that their level of skill and knowledge is appropriate to meet
client needs. In regard to counsellor competence, the ACA Code of Ethics and Practice states:
“3.10 Competence
(a) Counsellor Competence and Education
i.
Counsellors must have achieved a level of competence before commencing
counselling and must maintain continuing professional development as well as
regular and ongoing supervision.
ii.
Counsellors must actively monitor their own competence through counselling
supervision and be willing to consider any views expressed by their clients and
by other counsellors.
iii.
Counsellors must have a zero tolerance alcohol and illicit drug policy in their
workplace and, for the counsellor, up to eight hours before – and of course
during – their working hours. Counsellors are responsible for monitoring their
functioning and will not counsel when their functioning is impaired by alcohol
or drugs (be they illicit or licit). In situations of personal or emotional difficulty,
excessive tiredness or illness, counsellors will monitor the point at which they
are no longer competent to practice and take action accordingly. Counsellors
should always err on the side of caution in such cases.
iv.
Competence includes being able to recognise when it is appropriate to refer a
client elsewhere.
v.
Counsellors should take reasonable steps to seek out peer supervision to
evaluate their efficiency as counsellors on a regular basis as required by the
ACA (INC) membership guidelines.
vi.
Counsellors must recognise the need for continuing education in their chosen
profession to maintain a professional level of awareness of current scientific
and professional information and education in their particular fields of activity.
vii.
Counsellors should take steps to maintain and improve their level of
competence though on-going professional development and to keep up to date
with best practice.
viii. Counsellors are responsible for ensuring that their relationships with clients
are not unduly influenced by their own emotional needs.
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Study Guide 1: Counselling and the counselling process
ix.
x.
Counsellors must have professional indemnity insurance and maintain
adequate cover
When uncertain as to whether a particular situation or course of action may be
in violation of the Code of Ethics and Practice, counsellors must consult with
their counselling supervisor and/or other practitioners.”
(Australian Counselling Association, 2013b, p. 12)
As you can see, counsellor competence refers to many areas of practice, including professional
knowledge, referral, and attention to a counsellor’s own emotional needs. Counsellors must
ensure that they take care of their own emotional needs and manage stressors both in their
personal and professional lives. Counselling can be a mentally and emotionally challenging
role, therefore, it is important that counsellors become aware of their own strengths and
limitations and implement self-care strategies to ensure they do not experience vicarious
trauma or burnout. Adaptive coping and self-care strategies commonly used by counsellors
include taking care of themselves through exercise and a healthy lifestyle, expressing their
feelings, seeking support from their personal and professional networks, and using problem
solving techniques.
Self-reflection
Are you aware of your own personal strengths and limitations? What self-care strategies do
you currently use?
Reading F
Referral
Another responsibility that counsellors have to clients is that of appropriate referral.
According to the ACA Code of Ethics and Practice, counsellors should “endeavour to make
suitable referral where competent service cannot be provided” (Australian Counselling
Association, 2013a, p. 4) and is another aspect of counsellor competence. Understanding your
own competence, strengths, and limitations will help you to be realistic about the kinds of
clients and cases that you excel at and the areas that you may require more practise in. If you
feel that you lack experience and skills in a particular area of counselling you may need to refer
the client to a counsellor who specialises in that area. For example, if you are working with a
client who presents with depression only to find that she has deep seated post-traumatic stress,
an area you do not have experience in, you should either refer the client or ensure that you
have an experienced supervisor who can guide you in this work.
Some of the areas that specialist counselling services may be needed include:

Child protection issues – state or territory child protection agencies need to be
contacted if there are concerns about a child’s safety or suspicions of abuse or neglect.
The agency may take over the management of the case until the concerns have been
investigated or appropriate action has been taken.

Suicide prevention/intervention – beginner counsellors especially should ensure they
have the necessary support (e.g., from a supervisor or more experienced counsellor)
to deal with suicidal clients. In some cases the client may be hospitalised until they are
assessed as no longer a risk to themselves.

Domestic and family violence – counsellors should be aware of other agencies
specialising in domestic abuse and counselling. Knowledge of local services, such as
women’s or men’s shelters, is also important.
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Section 4: Counsellor responsibilities

Mental health issues – clients showing signs of psychiatric illness need to be referred
for appropriate specialist care. Indicators include hallucinations, strange or erratic
behaviour, extreme mood swings, agitation, aggression, extreme withdrawal, unusual
or exaggerated beliefs, paranoia, or problems with logical thinking.

Alcohol and other drugs issues – clients with substance abuse problems may require
referral to a range of specialist services such as medical services, detoxification centres,
rehabilitation services, or addictions counselling.

Other compulsions – depending on the counsellor’s training and experience,
behaviours such as compulsive gambling, compulsive eating or sex addiction may
require referral to an appropriate specialist.

Financial counselling – despite their title, financial counsellors have little in common
with the regular type of counsellor. Clients in financial difficulty may benefit from
seeing a financial counsellor for assistance with budgeting, debt management, and
dealing with debt collection agencies.

Bereavement issues – clients with complicated or traumatic grief reactions may be
referred to a grief specialist.

Physical illness – most counsellors do not have a medical background and should not
attempt to treat or give advice about clients’ physical health problems. Some clients
may require counselling in conjunction with medical treatment (e.g., clients with eating
disorders, chronic pain, or substance issues) and so will be working with more than
one professional at once. It is also wise to ensure that clients presenting with somatic
complaints (e.g., headaches, stomach pain) have been thoroughly medically evaluated.
If you work for a counselling service or other type of agency providing community services
you will need to follow organisational guidelines regarding referral. For example, your service
may have a policy that any client who is showing signs of acute mental illness or who mentions
that they have considered suicide should be referred immediately to a service that specialises
in helping people in these situations. This ensures that the client is thoroughly assessed and
receives the help they need, which may be hospitalisation or the services of a clinical outreach
team.
Most organisations/services will provide training for new counsellors in their policy regarding
referrals and how to recognise the signs that a client may need specialised services. In cases
where you are unsure whether a client requires referral or not, you should accurately and
objectively record the client’s behaviour, including what they have said that has caused you
concern. You should then discuss the matter with your supervisor or manager. By taking these
two steps you are acting in the best interests of the client, adhering to organisational guidelines,
and ensuring that you meet your duty of care responsibilities.
As Geldard and Geldard (2012) point out in the following extract, it is also important that
counsellors do not refer every difficult client they come across.
“When a client’s needs cannot be adequately met by a counselor, then that counselor has a
responsibility to make an appropriate referral, in consultation with the client, to another
suitable professional. However, it is not appropriate for a counselor to avoid all difficult and
unenjoyable work by excessively referring people to others. There is a responsibility on all
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Study Guide 1: Counselling and the counselling process
counselors to carry a fair load, and to be sensible about referral decisions. Such decisions are
best made in consultation with a supervisor.
It may sometimes be appropriate for a counselor to continue seeing a client while under
intensive supervision, instead of referring. If this happens, then the counselor has a
responsibility to inform the client.
Often, referral is useful where people have special needs. For example, people with particular
disabilities, people from other cultures and people who speak another language may benefit
from referral to an agency (or professional) that can provide for their specific needs.
When referring clients to others, it may be useful to contact the professional to whom the
referral is being made, with the client’s permission, to ensure that the referral is acceptable and
appropriate.”
(Geldard & Geldard, 2012, p. 266)
Some organisations will have a standard form that all outgoing referrals must be carried out
on. The following is an example of a client referral form.
CLIENT REFERRAL FORM
REFERRAL TO: (service) __________________________________________________
Date of Referral:
Client’s Details
Name:
Client consented to referral?
□ Yes □ No
DOB:
Gender:
□ Male
□ Female
Preferred Contact (e.g. phone, mobile, email, post):
Relationship:
Contact Phone:
Address:
Name of Next of Kin/Emergency Contact:
Indigenous/Cultural Identity:
Referrer Details:
Name:
Address:
Organisation and Position:
Email:
Phone:
Fax:
Reason/s For Referral
(Please include here any information which may be useful as background information to assist with the referral e.g.
Mental Health, Drug and Alcohol, Vocational/Educational, Physical Health, including past/current risk
assessments).
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Is the young person linked in with any other
services? Yes □ No □
If yes, please provide details:
Referrer signature: ______________________
Date: ______________
Source: Adapted from: www.headspace.org.au
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Section 4: Counsellor responsibilities
A note on the importance of exploring relationship alternatives
Some clients may benefit from additional or alternative services. We have already explored the
circumstances under which you may need to refer a client to another professional but at times
you may need to consider other options as well. In some circumstances, a client may gain
benefit from different types of support, for example, a client who has been coming to you for
some time for help in overcoming social phobia may benefit from actually joining a self-help
group for people with social phobia. This option would be most beneficial for a client who
has been attending counselling for some time and who has made progress but now needs to
take steps to maintain their progress. Similarly, a client who has been attending bereavement
counselling may find that they can benefit from joining a group where they can give and receive
support from others who have been through a similar experience.
Other options that can be offered in addition to individual face-to-face counselling or as an
alternative to counselling include:





Group counselling
Peer support
Self-help groups
Counselling hotlines or telephone counselling services
Online counselling
Monitoring the counselling process
Part of the counselling process involves checking that the client is satisfied with the counselling
that you are providing. This may involve giving the client a feedback form to fill in or
conducting a verbal review of the counselling process with the client. Reviews can be
conducted in a variety of ways. Some organisations will have procedures in place that outline
how counselling reviews are to be conducted. Nonetheless you may wish to conduct additional
reviews to assist you in assisting your client.
The initial counselling contract should outline the review process for the client. A review
should include:





Review of the progress that has been made towards the client’s goals.
Evaluation of the counselling relationship (from the client’s perspective).
Evaluation of the pace of the counselling progress.
Re-evaluation of the termination (final session) date.
Feedback from the client on what is working well for them and what is not.
The frequency of reviews is up to you and your client. Some counsellors choose to conduct a
brief review after every session; others choose a predictable time-frame, such as every three
sessions or every six weeks.
Counsellor responsibilities to their organisation
While a counsellor has many responsibilities to their client, they also have responsibilities to
themselves and to the organisation that they work for. Counsellors who work within
organisations must ensure that they understand their role within their organisation and what
is expected of them, as well as provide services according to organisational policies and
procedures. This means using counselling methods preferred by the organisation and working
within agency resources. Most organisations will have specific guidelines about how clients’
needs should be met and will expect that counselling staff adhere to these guidelines.
Counsellors should ensure that they are familiar with the organisation’s policies and
procedures regarding working with clients, including being familiar with the maintenance of
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Study Guide 1: Counselling and the counselling process
client records, Work Health and Safety (WHS) guidelines, and need for professional
supervision.
Most organisations/agencies require staff to document each client session in the form of case
notes. If these are handwritten, they must be kept in the client’s file in a secure location not
easily accessible by third parties (e.g., a locked filing cabinet in the counsellor’s office, which
is also locked overnight). These days, most organisations document electronically (or use a
combination of electronic and handwritten documentation). Maintaining client documentation
electronically involves a number of considerations, including:

Security – who can access the computer or other hardware? Is it password protected?
If files are stored on a central server, are there appropriate restrictions in place for their
access? Is there internet security/virus protection installed?

Physical premises – check your organisation’s policy about client files leaving the
premises. For example, if you take work home on a USB stick you will need to take
extra precautions to protect that information.

Health and safety issues – the use of any information technology must occur in line
with Work Health and Safety (WHS) guidelines. Typically these include things like
workspace setup, posture and appropriate seating, taking regular breaks from the
computer screen, and ensuring electronic devices are regularly serviced and maintained
so as to reduce fire hazards.
Summary
In this section you were introduced to the responsibilities you will have as a counsellor,
including respecting client confidentiality, professional boundaries, and ensuring that you have
the appropriate skills and competence. This section also outlined the process of referral and
some of the responsibilities counsellors have to the organisations for which they work. You
will learn much more about these responsibilities as you progress through your Diploma.
References
Australian Counselling Association (2013a). ACA policy document on professional supervision.
Retrieved from:
https://www.theaca.net.au/documents/ACA%20Supervision%20Policy%202013.pdf
Australian Counselling Association (2013b). Code of ethics and practice of the association for counsellors
of Australia. Retrieved from:
http://www.theaca.net.au/documents/ACA%20Code%20of%20Ethics%20and%20Pra
ctice%20Ver%2010.pdf
Geldard, K., & Geldard, D. (2012). Personal counseling skills: An integrative approach. Springfield,
IL: Charles C Thomas.
Headspace. (n.d.). Referral form. Retrieved from
http://www.headspace.org.au/media/301131/headspace%20referral%20form.doc
Assessment activities
Assessment activities relevant to this section are contained in Section 4 of your Assessment
Book.
56
READINGS A – G
57
58
Reading A
An Introduction to Counselling (5th ed.)
John McLeod
Open University Press
Berkshire, UK, 2013
PART I: PGS 3 – 16
PART II: PGS 31 – 35
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Study Guide 1: Counselling and the counselling process
PART I:
WHAT IS COUNSELLING?
Introduction
challenging. There is always more to learn.
The role of counsellor lends itself to flexible
work arrangements. There are excellent
counsellors who are full-time paid staff;
others who work for free in the evenings for
voluntary agencies; and some who are able
sensitively to offer a counselling relationship
within other work roles, such as nurse,
doctor, clergy, social worker, or teacher.
Counselling is an activity that emerged during
the twentieth century, and reflects the
pressures and values of modern life. We live
in a complex, busy, changing world. In this
world, there are many different types of
experiences that are difficult for people to
cope with. Most of the time, we get on with
life, but sometimes we are stopped in our
tracks by an event or situation that we do not,
at that moment, have the resources to sort
out. Most of the time we find ways of dealing
with such problems in living by talking to
family, friends, neighbours, priests or our
family doctor. But occasionally their advice is
not sufficient, or we are too embarrassed or
ashamed to tell them what is bothering us, or
we just do not have an appropriate person to
turn to. Counselling is a really useful option
at these moments. In most places,
counselling is available fairly and quickly, and
costs little or nothing. The counsellor is
someone who does his or her best to listen to
you and work with you to find the best ways
to understand and resolve your problem.
Counsellors do not diagnose or label people,
but instead do their best to work within
whatever framework of understanding makes
most sense for each client. For some people,
one conversation with a counsellor is
sufficient to make a real difference to them.
Other people will need to see their counsellor
on a regular basis for months or years. These
can be precious hours. Where else in our
society is there the opportunity to be heard,
taken seriously, understood, to have the
focused attention of a caring other for hours
at a time without being asked to give anything
in return?
This book is about counselling. It is a book
that celebrates the creative simplicity of
counselling as a cultural invention that has
made a huge contribution to the quality of life
of millions of people. The aim of this book is
to provide a framework for making sense of
all the different aspects of counselling that
exist in contemporary society, while not
losing sight of its ordinary simplicity and
direct human value.
Counselling in action
The following paragraphs reflect some
typical examples of counselling, in terms
both of different problems in living that can
be tackled through counselling, and the
different counselling processes that can
occur.
Donald's story: coming to terms with the
pressure of work
As a manager in a local government
department, Donald continually felt himself
to be under pressure, but able to cope.
Following a series of absences for minor
illnesses, the occupational health nurse
within the authority suggested to Donald that
it might be helpful for him to see one of the
counsellors contracted to the occupational
health service. Initially, Donald thought it
would be a sign of weakness to see a
counsellor. He was also worried that other
people in the organization might view him as
having mental health problems, and begin to
see him as unreliable. Following further
discussion with the occupational health
nurse, Donald accepted that counselling was
completely confidential, and might have
something to offer. In the eight counselling
sessions that he attended, Donald made two
important discoveries about himself. First, he
Being a counsellor is also a satisfying and
rewarding work role. There are times when,
as a counsellor, you know that you have made
a profound difference to the life of another
human being. It is always a great privilege to
be allowed to be a witness and companion to
someone who is facing their own worst fears
and dilemmas. Being a counsellor is endlessly
60
Reading A
realized the extent to which he was driven by
his father's ambition for him, to the extent of
never being satisfied with his own
achievements, and as a result being very
reluctant to take holidays from work. He also
reflected, with the help of his counsellor, on
his unwillingness to accept support from
other people, not only at work, but also in the
context of his family life. With the
encouragement of his counsellor, Donald
began to make some shifts in his behaviour,
in relation to arranging time off, and making
opportunities to speak about his concerns to
his wife, and to another close colleague. At
the end of the counselling, he described it as
having given him an opportunity to 'sort
himself out'.
Maria and her counsellor developed
strategies that allowed her to deal with the
many demands of her nurse training. As
Maria gradually built up a sense of herself as
competent, likeable, and strong, she became
more able to leave behind much of her
fearfulness and tendency to engage in binge
eating.
Arva's story: whether to leave a marriage
Having been married for five years to a man
whose family were prominent members of a
leading family within the Asian community in
her city; the idea of marital separation and
divorce was terrifying for Arva. Although she
was no longer willing to accept the physical
violence of her husband, she was at the same
time unable to envisage that any other life
might be open to her if, as she put it, she
'walked away' from her community.
Eventually, Arva made an appointment to
speak to a counsellor at a domestic violence
helpline. Reassured by the acceptance she felt
from the counsellor, she agreed to come in
for a face-to-face appointment. Initially, Arva
was very unsure about whether her
counsellor could help her, because it did not
seem that the counsellor understood the
meaning and implications, within Arva's
cultural group, of leaving marriage or publicly
accusing a husband of mistreating his wife.
Over time, the counsellor developed a
sufficient understanding of Arva's experience
to allow the counselling to proceed. The
counsellor also helped Arva to make contact
with an Asian women's support group and a
legal advice centre, both of which were
helpful to her in providing a broader
perspective on her position. Eventually, Arva
courageously confronted her husband about
his behaviour. To her surprise, he agreed to
join her in joint counselling, in which they
agreed on some better ways to resolve the
conflicts that sometimes arose between
them.
Maria's story: moving on from abuse
At the age of 25, Maria's emotional life and
relationships were still dominated by her
memories of having been subjected to
physical and sexual abuse in her childhood.
She found it very hard to trust other people,
or to speak up in social situations. For the
most part, Maria had decided that the best
course of action for survival was to be as
invisible as possible. Although at various
stages in her life she had tried to talk about
her experiences to various doctors,
psychiatrists and nurses, she had always felt
that they did not really want to know what
had happened to her, and were more
interested in prescribing various forms of
drug treatment to control her anxiety and
self-harming behaviour. However, she had
made enough progress in her recovery to
decide to go to university to train as a nurse.
Once started on her course, she found herself
confronted by a variety of frightening
situations – talking in seminar groups,
making new friends, being on placement in
busy hospital wards. Maria decided to visit
the university student counselling service.
This was the first time in her life that she had
ready access to any form of psychological
therapy. Maria formed a strong relationship
with her counsellor, who she occasionally
described as 'the mother I never had', and
attended counselling weekly throughout the
entire three years of her training. Together,
Anita's story: dealing with loss
Married to Bill for 40 years, Anita was
devastated by his sudden death within six
months of his retirement. Although Anita felt
herself to be fortunate, in enjoying regular
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Study Guide 1: Counselling and the counselling process
contact with her son and daughter and
several grandchildren, she increasingly felt
that her life was meaningless, and that she
would never get over the loss of her beloved
Bill. Nine months after his death, she visited
her GP, who suggested a course of antidepressants. Unhappy about the idea of
possibly becoming dependent on drugs,
Anita asked if there were any other
alternatives. The GP then referred her to a
bereavement counselling service. Anita only
attended the counselling on two occasions,
and did not find it helpful. When asked
afterwards about why she thought that the
counselling had not been useful for her, she
said: 'he was a nice man, but he just sat and
listened, and I felt worse. I couldn’t see any
point in it'.
when they occurred. He also began to
cultivate a subtly different image within the
school, and within his own imagination – the
'joker' rather than the 'troublemaker'.
Defining counselling
The case vignettes presented above give
some brief examples of what can happen
when someone goes to see a counsellor. But
what is counselling? What are the ideas and
principles that link together the very different
experiences of these counselling clients?
How can we understand and define
counselling? These are some definitions of
'counselling' formulated by professional
bodies and leading figures in the field.
… a professional relationship between a
trained counsellor and a client…
designed to help clients to understand
and clarify their views of their lifespace,
and to learn to reach their self-determined
goals through meaningful, well-informed
choices and through resolution of
problems of an emotional or
interpersonal nature.
(Burks and Stefflre 1979: 14)
Simon's story: creating a new self-image
By the age of 13, Simon had acquired a
reputation as a 'difficult' student. Often
required to attend detention on the basis of
aggressive and uncooperative behaviour,
Simon was on the edge of being suspended
from school. His form teacher persuaded
him that it would do no harm to see the
school counsellor. In his first counselling
session, Simon sat with his arms crossed,
reluctant to talk. However, on the basis that
speaking to someone who genuinely seemed
interested in his side of things was better than
attending maths class, he gradually allowed
himself to open up. From Simon's
perspective, he felt trapped in an image that
other people had of him. Physically strong
and mature for his age, and from a family that
believed in the value of standing up for
yourself, Simon felt that he had made the
mistake, early in his career at the school, of
challenging one teacher who had (in Simon's
eyes) unfairly accused him of a
misdemeanour. Ever since that day, it seemed
not only other teachers, but also his
classmates, seemed to expect him to 'rise to
the bait' whenever a teacher reprimanded
him. He admitted that he felt 'fed up and
stuck' with this pattern, but could not find
any way to change it. With the counsellor's
help, Simon identified some key trigger
situations, and ways of responding differently
... a principled relationship characterised
by the application of one or more
psychological theories and a recognised
set of communication skills, modified by
experience,
intuition
and
other
interpersonal factors, to clients' intimate
concerns, problems or aspirations.
(Feltham and Dryden 1993: 6)
Counselling and psychotherapy are
umbrella terms that cover a range of
talking therapies. They are delivered by
trained practitioners who work with
people over a short or long term to help
them bring about effective change or
enhance their wellbeing.
(British Association for Counselling and
Psychotherapy website 2013)
Counselling is a professional relationship
that empowers diverse individuals,
families, and groups to accomplish
62
Reading A
mental health, wellness, education, and
career goals.
(American Counseling Association
website 2013)
that they have not been able to resolve
through their everyday resources, and that
has resulted in their exclusion from some
aspect of full participation in social life. The
concept of 'problem in living' can be
understood to refer to any situation or
perceived difficulty or impediment that
prevents a person from getting on with his or
her life. Counselling is not focused on
symptom reduction, but on enabling the
person to live their life in a way that is most
meaningful and satisfying to him or her.
These definitions share one important
feature in common: they are primarily framed
from the point of view of the counsellor. They
are definitions that primarily seek to define
counselling as ‘something done by a
counsellor’. In taking this perspective, these
definitions reflect the aim of professional
bodies to establish counselling as a
professional specialism within contemporary
society. However, a profession-centred
definition of counselling runs the risk of
ignoring the basic fact that counselling is
always a two-person (or multiperson) activity,
which arises when one person seeks the help
of another. In order to reflect a more
inclusive meaning of the team ‘counselling’,
this book espouses a user-centred definition:
3. Counselling is fundamentally based on
conversation, on the capacity of people to
'talk things through' and to generate new
possibilities for action through dialogue.
4. Counselling depends on the creation of a
relationship between two people, which is
sufficiently secure to allow the person
seeking help to explore issues that are painful
and troubling.
Counselling is a purposeful, private
conversation arising from the intention of
one person (couple or family) to reflect
on and resolve a problem in living and the
willingness of another person to assist in
that endeavour.
5. The person seeking counselling possesses
strengths and resources that can be
channelled in the service of resolving a
problem in living. The act of seeking
counselling is not viewed as an indicator of
personal deficiency or pathology.
The key assumptions that underpin, and are
implied by, this definition include:
6. The person in the role of counsellor does
not necessarily possess special training or
knowledge of psychological theories –
counselling is grounded in ordinary human
qualities such as a capacity to listen,
sensitivity to the experience of others,
personal integrity, and resourcefulness in
solving the difficulties that arise in everyday
life.
1. Counselling is an activity that can only
happen if the person seeking help, the client,
wants it to happen. Counselling takes place
when someone who is troubled invites and
allows another person to enter into a
particular kind of relationship with them. If a
person is not ready to extend this invitation,
they may be exposed to the best efforts of
expert counsellors for long periods of time,
but what will happen will not be counselling.
The person seeking counselling is regarded as
actively engaged in finding ways of
overcoming his or her problems, and as a coparticipant in the counselling process, rather
than as a passive recipient of intervention.
7. The person seeking counselling invites
another person to provide him or her with
time and space characterized by the presence
of a number of features that are not readily
available in everyday life: permission to
speak, respect for difference, confidentiality,
and affirmation.
2. A person seeks a counselling relationship
when they encounter a 'problem in living'
a) Encouragement and permission to speak.
Counselling is a place where the person
63
Study Guide 1: Counselling and the counselling process
can tell their story, where they are given
every encouragement to give voice to
aspects of their experience that have
previously been silenced, in their own
time and their own way, including the
expression of feelings and emotion.
a) Resolution of the original problem in
living. Resolution can include: achieving
an understanding or perspective on the
problem, arriving at a personal acceptance
of the problem or dilemma, and taking
action to change the situation in which the
problem arose.
b) Respect for difference. The counsellor
sets aside, as far as they are able, their own
position on the issues brought by the
client, and his or her needs in the moment,
in order to focus as completely as possible
on helping the client to articulate and act
on his or her personal values and desires.
b) Learning.
Engagement
with
counselling may enable the person to
acquire new understandings, skills, and
strategies that make them better able to
handle similar problems in future.
c) Social inclusion. Counselling stimulates
the energy and capacity of the person as
someone who can contribute to the wellbeing of others and the social good.
c) Confidentiality. Whatever is discussed
is confidential: the counsellor undertakes
to refrain from passing on what they have
learned from the person to any others in
the person's life world.
10. Counselling always exists within a social
and cultural context: 'counsellor' and 'client'
are social roles, and the ways in which
participants make sense of the aims and work
of counselling are shaped by the broad
cultural and specific community and
organizational contexts within which they
live. The practice of counselling is informed
by awareness and appreciation of social,
cultural, historical, and economic factors.
The meaning of 'counselling', and the forms
of practice associated with this term,
continually evolve in response to social and
cultural change.
d) Affirmation. The counsellor enacts a
relationship that is an expression of a set
of core values: honesty, integrity, care,
belief in the worth and value of individual
persons, commitment to dialogue and
collaboration,
reflexivity,
the
interdependence of persons, a sense of the
common good.
Counselling practice is therefore grounded in
a distinctive set of values, and moral position,
based on respect and affirmation of the
worth of the individual person.
11. Counselling is readily accessible. It is a
‘frontline’ service, that is located within the
community or organization where the person
lives, works or studies. There is minimal
‘gatekeeping’ that needs to be negotiated in
order to see a counsellor.
8. Counselling represents an arena for
support, reflection, and renewal that is
unique within modern societies. Within this
arena, the client and counsellor make use of
whatever cultural resources come to hand
(conversation, ideas, theories, rituals, altered
states of consciousness, problem-solving
algorithms, discourses, technologies) to
achieve a satisfactory resolution of the initial
problem in living that initiated the decision to
engage in counselling.
It can be seen that a user-centred description
of counselling highlights a range of factors
that are partially hidden in profession-centred
definitions.
User-centred
language
characterizes the person seeking counselling
as active and resourceful, and purposefully
seeking to resolve problems in living, rather
than merely a recipient of 'treatment'. It also
emphasizes the connection between
counselling and the social world of which the
9. The potential outcomes of counselling can
be understood as falling into three broad
categories:
64
Reading A
person is a member. It characterizes
counselling as a relationship, a space, or an
opportunity that is sought by a troubled
person, rather than as any particular form of
practice (e.g. two people sitting talking to
each other face to face) – thereby inviting
creativity and exploration in relation to how
this space and opportunity might be
constructed. It makes no claim that a
professional qualification, or formal
knowledge of psychology, is necessary in
order to practise counselling – effective
counselling can take place both within and
outside professionalized networks.
How does counselling help?
The concept of diversity is central to an
understanding of what counselling is about.
Counselling is a form of helping that does its
best to respect and work with the diverse
needs and learning styles of different clients.
Because counselling is a frontline service,
counsellors are not specialists in one single
approach to therapy. Instead, counsellors
need to be able to work with whatever and
whoever walks through the door, or makes
contact by phone or by other means.
Effective counsellors are responsive and
creative in their capacity to find out what will
be most helpful for each individual client.
There are many ways in which counselling
can help people to move on in their lives:



Insight. The acquisition of an
understanding of the origins and
development of emotional difficulties,
leading to an increased capacity to take
rational control over feelings and actions.
Relating with others. Becoming better able
to form and maintain meaningful and
satisfying relationships with other people:
for example, within the family or
workplace.
Self-awareness. Becoming more aware of
thoughts and feelings that had been
blocked off or denied, or developing a
more accurate sense of how self is
perceived by others.
65

Self-acceptance. The development of a
positive attitude towards self, marked by
an ability to acknowledge areas of
experience that had been the subject of
self-criticism and rejection.

Self-actualization
or
individualization.
Moving in the direction of fulfilling
potential or achieving an integration of
previously conflicting parts of self.

Enlightenment. Assisting the client to arrive
at a higher state of spiritual awakening.

Problem-solving. Finding a solution to a
specific problem that the client had not
been able to resolve alone. Acquiring a
general competence in problem-solving.

Psychological education. Enabling the client
to acquire ideas and techniques with
which to understand and control
behaviour.

Acquisition of social skills. Learning and
mastering social and interpersonal skills
such as maintenance of eye contact, turntaking in conversations, assertiveness or
anger control.

Cognitive change. The modification or
replacement of irrational beliefs or
maladaptive thought patterns associated
with self-destructive behaviour.

Behaviour change. The modification or
replacement of maladaptive or selfdestructive patterns of behaviour.

Systematic change. Introducing change into
the way in that social systems (e.g.
families) operate.

Empowerment. Working on skills,
awareness and knowledge that will enable
the client to take control of his or her
own life.

Restitution. Helping the client to make
amends for previous destructive
behaviour.
Study Guide 1: Counselling and the counselling process

approaches and techniques, but are
required to use different titles in response
to the demands of the agencies that
employ them. For example, traditionally
psychotherapy has been the term used in
medical settings such as psychiatric units,
and counselling the designation for
people working in educational settings
such as student counselling services.
Generativity and social action. Inspiring in the
person a desire and capacity to care for
others and pass on knowledge
(generativity) and to contribute to the
collective good through political
engagement and community work.
Counselling should be flexible enough to
make it possible for the client to use the
therapeutic relationship as an arena for
exploring whatever dimension of life is most
relevant to their well-being at that point in
time.
One of the difficulties with both of these
positions is that each of them portrays
counselling in a 'little sister' role in relation to
psychotherapy. In the 'clear distinction'
position, counselling is explicitly described as
less effective. In the 'no difference' position,
counselling is still placed in a lesser position,
by dint of the fact that psychotherapy jobs are
higher status and better paid than counselling
posts, even when they involve doing
equivalent work.
What is the difference between
counselling and
psychotherapy?
The degree of similarity and difference
between counselling and psychotherapy has
been the focus of considerable debate. This
issue is made more complex by the fact that,
while all English-language societies employ
both terms, there are many countries in
which only the term 'psychotherapy' is used
(e.g. Sweden) and other countries in which
'psychotherapy' is mainly used but where
there are ongoing attempts to create a
distinction between counselling and
psychotherapy (e.g. Germany, where there is
a movement to use 'Beratung' as the
equivalent to 'counselling'). Within the
English
language
community,
two
contrasting positions have dominated this
debate:

A clear distinction can be made between
counselling and psychotherapy. The argument
here is that, although there is a certain
amount of overlap between the theories
and methods of counsellors and
psychotherapists, and the type of clients
that they see, there is nevertheless a
fundamental difference between the two,
with psychotherapy representing a
deeper, more fundamental level of work,
over a longer period, usually with more
disturbed clients.

Counsellors and psychotherapists are basically
doing the same kind of work, using identical
Many people who work as counsellors are
dissatisfied with the 'little sister' image of
their professional role because they know
that they work with some of the most
damaged people in society, and believe that
what they do is as effective as any form of
psychotherapy. In recent years there has
emerged a view that counselling and
psychotherapy
comprise
alternative
approaches to responding to the needs of
people who experience problems in living.
Some key points of contrast between
counselling
and
psychotherapy
are
summarized in Table 1.1.
It is essential to acknowledge that none of the
statements of difference in Table 1.1
represent an absolute difference between
counselling and psychotherapy. In reality, the
domains of counselling and psychotherapy
are fragmented and complex, and embrace a
multiplicity of forms of practice. It would not
be hard to find examples of psychotherapy
practice that correspond to characteristics
attributed in Table 1.1 to counselling (and
vice versa); there is a huge degree of overlap
between counselling and psychotherapy. It is
best to regard these differences between
counselling and psychotherapy as indicative
66
Reading A
TABLE 1.1 Similarities and differences between counselling and psychotherapy
Psychotherapy
Counselling
Provides the person with a confidential space
in which to explore personal difficulties
Provides the person with a confidential space in
which to explore personal difficulties
Effective practice depends to a great extent
on the quality of the client-psychotherapist
relationship
Effective practice depends to a great extent on
the quality of the client-counsellor relationship
Self-awareness and personal psychotherapy
are valued elements of training and ongoing
development
Self-awareness and personal therapy are valued
elements of training and ongoing development
Similarities
Differences
A wholly professionalized occupation
An activity that includes specialist professional
workers,
but
also
encompasses
paraprofessionals, volunteers, and those whose
practice is embedded within other occupational
roles
Public perception: inaccessible, expensive,
middle class
Public perception: accessible, free, working class
Perception by government/state: given
prominent role in mental health services;
strongly supported by evidence-based
practice policies
Perception
invisible
Conceptualizes the client as an individual
with problems in psychological functioning
Conceptualizes the client as a person in a social
context
Training and practice focuses on delivering
interventions
Training and practice involves not only
delivering interventions, but also working with
embedded colleagues, and promoting self-help
Psychotherapy agencies are separate from
the communities within which they are
located
Counselling agencies are part of their
communities – e.g. a student counselling service
in a university
Treatment may involve the application of
interventions defined by a protocol, manual
or specific therapy model
The helping process typically involves
counsellor and client working collaboratively,
using methods that may stretch beyond any
single protocol or manual
Treatment has a theory-derived brand name
(e.g. interpersonal therapy, CBT, solutionfocused therapy)
Often has a context-derived title (e.g. workplace
counselling, bereavement counselling, student
counselling)
Many psychotherapists have a psychology
degree, which functions as a key entrance
qualification
Counsellors are likely to be drawn from a wide
variety of backgrounds; entrance qualification is
life experience and maturity rather than any
particular academic specialism
Predominant focus on the pathology of the
person
Predominant focus on personal strengths and
resources
67
by
government/state:
largely
Study Guide 1: Counselling and the counselling process
of a direction of travel that is occurring
within the therapy professions, rather than as
constituting any kind of fixed map of what is
happening now. Nevertheless, a conception
of counselling as a distinctive contextually
oriented, strengths-based and pragmatic
form of practice reflects a trajectory that is
clearly visible within the international
counselling community. This book seeks to
acknowledge the substantial similarities and
overlap
between
counselling
and
psychotherapy, while at the same time
reinforcing the distinctive nature of
counselling.
years, some counsellors have started to
describe their work as life coaching or executive
coaching. Coaching is an activity that draws on
much of the skill and knowledge of
counselling, but is focused on the promotion
of positive effectiveness and achievement,
rather than on the amelioration of problems.
Finally, there is a large degree of overlap
between the use of the terms ‘counselling’
and ‘psychotherapy’, as discussed in the
preceding section of this chapter.
There also exists a wide diversity in
counselling practice, with counselling being
delivered through one-to-one contact, in
groups, with couples and families, over the
telephone and Internet, and through written
materials such as books and self-help
manuals. Counselling is practised in a range
of different settings, and offered to a wide
array of client groups.
Where can I find a counsellor?
There are several occupational titles that refer
to people who are practising counselling. A
term that is sometimes used is counselling
psychologist. This refers to a counsellor who
has initial training in psychology, and whose
work
is
specifically
informed
by
psychological methods and models. There
are also several labels that refer to counsellors
who work with particular client groups: for
example, mental health counsellor, marriage/couple
counsellor, bereavement counsellor or student
counsellor. These practitioners possess
specialist training and expertise in their
particular field in addition to general
counselling training. There are also many
instances where counselling is offered in the
context of a relationship that is primarily
focused on other, non-counselling concerns.
For example, a student may use a teacher as
a person with whom it is safe to share worries
and anxieties. A community nurse may visit a
home to give medical care to a patient who is
terminally ill, but finds herself also providing
emotional support. In these situations it
seems appropriate to describe what is
happening as embedded counselling (McLeod and
McLeod, 2011). Embedded counselling is, or
can be, an aspect of a wide range of
professional roles: clergy, teaching, health,
social work and community work, legal and
justice work, personnel, human resources
and management, and much else. Embedded
counselling also takes place in a variety of
peer self-help networks, such as Alcoholics
Anonymous and Weightwatchers. In recent
This diversity of theory and practice can be
attributed to the fact that counselling
emerged and grew during the twentieth
century in response to a mix of cultural,
economic and social forces. In essence,
because it is targeted at individuals and small
groups, and focuses on the personal needs of
each client, counselling represents a highly
flexible means of responding to societal
problems. For example, many counselling
agencies are funded by, or attached to,
organizations that have a primary task of
providing medical and health care. These
range from mental health/psychiatric
settings, which typically deal with highly
disturbed or damaged clients, through to
counselling available in primary care settings,
such as GP surgeries, and from community
nurses. There has also been a growth in
specialist counselling directed towards
people with particular medical conditions
such as AIDS, cancer and various genetic
disorders. Counselling has also played an
important role in many centres and clinics
offering alternative or complementary health
approaches. One of the primary cultural
locations for counselling and psychotherapy
can therefore be seen to be alongside
medicine. Even when counsellors and
68
Reading A
counselling agencies work independently of
medical organizations, they will frequently
establish some form of liaison with medical
and psychiatric services, to enable referral of
clients who may require medical or nursing
care. These areas of counselling practice
reflect the increasing medicalization of social
life (Turner 1995), and the pressure to create
a space for personal contact and relationship
within technologically driven health care.
cessation. The social role of the counsellor
can be seen particularly clearly in this type of
work. In some areas of addiction counselling,
such as with hard drug users, counsellors
operate alongside a set of powerful legal
constraints and moral judgements. The
possession and use of heroin, for example, is
seen by most people as morally wrong, and
has been made a criminal offence. The
counsellor working with a heroin addict,
therefore is not merely exploring ways of
living more satisfyingly and resourcefully, but
is mediating between competing social
definitions of what an acceptable 'way of
living' entails. In other fields of addiction
counselling, such as food, alcohol and
cigarette abuse, the behaviour in question is
heavily reinforced by advertising paid for by
the slimming, drink and tobacco industries.
The incidence of alcohol-and-smokingrelated diseases would be more effectively
reduced by tax increases than by increases in
the number of counsellors, an insight that
raises questions about the role of counselling
in relation to other means of control of
behaviour.
Counselling also has a place in the world of
work. A variety of counselling agencies exist
for the purpose of helping people through
difficulties, dilemmas or anxieties concerning
their work role. These agencies include
vocational guidance, student counselling
services
and
employee
assistance
programmes or workplace counselling
provided by large organizations in industry
and the public sector. Whether the work role
is that of executive, postal worker or college
student, counsellors are able to offer help
with stress and anxiety arising from the work,
coping with change and making career
decisions.
A number of counselling agencies have
evolved to meet the needs of people who
experience traumatic or sudden interruptions
to their life development and social roles.
Prominent among these are agencies and
organizations offering counselling in such
areas as marital breakdown, rape and
bereavement. The work of the counsellor in
these agencies can very clearly be seen as
rising from social problems. For example,
changing social perceptions of marriage,
redefinitions of male and female roles, new
patterns of marriage and family life, and
legislation making divorce more available
represent major social and cultural changes
of the past century. Counselling provides a
way of helping individuals to negotiate this
changing social landscape.
The significance of paying attention to the
context within which counselling takes place
arises from an appreciation that counselling
is not merely a process of individual learning.
It is also a social activity that has a social
meaning. Often, people turn to counselling at
a point of transition, such as the transition
from child to adult, married to divorced,
addict to straight, or when they are struggling
to adapt to social institutions. Within these
contexts, counsellors are rarely managers or
executives who hold power in colleges,
businesses or communities. Counsellors,
instead, have a more 'liminal' role, being
employed at the edge of these institutions to
deal with those in danger of falling off or
falling out.
A further field of counselling activity lies in
the area of addictions. There exists a range of
counselling approaches developed to help
people with problems related to drug and
alcohol abuse, food addiction and smoking
The aim of this chapter has been to provide
an image of the complex mosaic of
contemporary counselling practice. From the
point of view of the user or client, counselling
can be understood as a relationship and a
Conclusions
69
Study Guide 1: Counselling and the counselling process
conversational space that enables problems
in living to be explored and resolved.
Counselling is a flexible form of helping, that
respects diversity and strives to understand
problems from the point of view of the client,
rather than trying to fit the client to a preexisting diagnostic system. At its best,
counselling is a frontline, community-based
service that is readily accessible to people
who need it. As a result, counselling is
available in a wide range of community
settings. The implications of this image of
counselling, and the ways in which it has been
interpreted and articulated by practitioners
and organizations, are explored in the
following chapters.
advisory services. In Britain, the Standing
Council for the Advancement of
Counselling, which was later to become the
British Association for Counselling was
inaugurated in 1971, by a network of people
who were primarily based in social services,
social work and the voluntary sector.
The precursors to the formation of these
organizations can be understood in terms of
a sense of crisis within society, or ‘moral
panic’, around various areas of social life. In
effect, what happened was that there was a
sense of unease around some aspect of the
breakdown of social order, or the
identification of groups of individuals who
were being unfairly treated in some way.
These crises were characterized by
widespread publicity about the problem,
debate in newspapers and magazines, and
efforts to bring about political or legislative
change. At some point in this process,
someone would have the idea that the best
means of helping was to treat each person
needing assistance as an individual, and that
the most effective way to proceed was to sit
down with that individual, discuss the matter,
and find the best way forward for that person
in terms of his or her unique needs and
circumstances. The idea of ‘counselling’
appears to have emerged more or less
simultaneously, in many different fields of
social action, in this manner.
PART II:
The emergence of counselling
The history of psychotherapy has been much
more fully documented than the history of
counselling. Counselling, as a distinct
profession came of age only in the 1940s.
One of the public markers of the emergence
of counselling at that time was that Carl
Rogers, in the face of opposition from the
medical profession to the idea that anyone
without medical training could call himself a
‘psychotherapist’, began to use the term
‘counselling and psychotherapy’ to describe
his approach (Rogers, 1942). Although in
many respects counselling, both then and
now, can be seen as an extension of
psychotherapy, a parallel activity or even a
means of ‘marketing’ psychotherapy to a new
groups of consumers, there are also at least
two important historical strands that
differentiate
counselling
from
psychotherapy:
involvement
in
the
educational system and the role of the
voluntary sector. The American Personnel
and Guidance Association, which was later to
become
the
American
Counselling
Association was formed in 1952, through the
merger of a number of vocational guidance
professional groups that were already well
established by that time. The membership of
American
Personnel
and
Guidance
Association consisted of counsellors who
worked in schools, colleges, and career
Probably the first recorded example of this
kind of ‘invention of counselling’ was in the
work of American social reformer Frank
Parsons (1854-1908). In his earlier years,
Parsons had been employed as an engineer,
lawyer and writer, before turning to lecturing
at Boston University. He was well known,
internationally, for his writing and lecturing
that argued against the uncontrolled
capitalism of the time, and proposed that it
should be replaced by a philosophy of
mutualism – ‘the replacement of competition
by cooperation, and lust for money by
concern for humanity’ (Gummere, 1988:
403). He campaigned for votes for women,
and public ownership of key industries. In
the final years of his life, Parsons came to be
70
Reading A
particularly interested in the issue of helping
young people to be matched with jobs that
were right for them. He established a
‘Vocation Bureau’ in an immigrant district of
Boston, where young people were
interviewed and assessed, provided with
information about possible career choices,
and provided with opportunities to explore
their feelings around the work they would
like to do. The philosophy of the Bureau was
clearly grounded in what we now consider to
be a counselling approach: ‘no person shall
decide for another what occupation he
should choose, but it is possible to help him
to approach the problem that he shall come
to a wise conclusion for himself’ (Parsons,
1909: 4). The Vocation Bureau operated as an
example and catalyst for the expansion of
counselling provision in schools and
vocational guidance services, throughout the
USA (O’Brien 2001). Counselling of various
kinds came to be offered within the school
and college systems in the 1920s and 1930s,
as career guidance and also as a service for
young people who were having difficulties
adjusting to the demands of school or college
life. Psychological testing and assessment was
bound up with these activities, but there was
always an element of discussion or
interpretation of the student’s problems or
test results (Whiteley 1984).
a response to perceived social breakdown
and crisis in areas such as rape, bereavement,
gay and lesbian issues and child abuse. As
with the National Marriage Guidance
Council, many of these initiatives were led by
Church groups. For example, in Scotland,
many counselling agencies owe their
existence to the pioneering work of the
Board of Social Responsibility of the Church
of Scotland.
A further early example of the use of a
counselling approach in response to a social
problem can be found in the employee
counselling scheme introduced in 1936 in the
Hawthorne plant of the Western Electric
manufacturing company (Dickson 1945;
Dickson and Roethlisberger 1966; Levinson
1956; Wilensky and Wilensky 1951). In this
project, counsellors were available to
employees on the shop floor, to talk about
any issues (both work based and personal)
that might be affecting their capacity to do
their job. The rationale for the provision of
counselling was that the management of the
company acknowledged the pressures of
working on a production line, and sought to
maintain workforce well-being both as a
welfare response, and also as a means of
maximizing productivity and reducing staff
turnover. The acceptability and popularity of
this service on the part of workers, was
documented in an evaluation of the scheme
by Dickson and Roethlisberger (1966), which
found that over a three-month period, 36 per
cent of the workforce made use of
counselling, with 10 per cent of those who
used it reporting that it had been very helpful.
In Britain, counselling had strong roots in the
voluntary sector. For example, the largest
single counselling agency in Britain, the
National Marriage Guidance Council (now
RELATE), dates back to 1938, when a
clergyman, Dr Herbert Gray, mobilized the
efforts of people who were concerned about
the threat to marriage caused by modern life
(Tyndall 1985). The additional threat to
married life introduced by World War II led
to the formal establishment of the Marriage
Guidance Council in 1942. A comprehensive
historical analysis of the growth of the
National Marriage Guidance Council, in
response to societal and governmental alarm
about divorce rates and marital breakdown,
has been published by Lewis et al. (1992).
Since that time, many other groups of
volunteers have set up counselling services as
These examples of critical moments in the
emergence of counselling illustrate the
existence of a distinct historical tradition,
which has primarily arisen from a social
action perspective rather than an individual
pathology orientation. Although there has
been much mutual interaction and influence
across
counselling-psychotherapy
professional communities, from a historical
vantage point it is possible to see that they are
each culturally positioned in somewhat
different territories.
71
Study Guide 1: Counselling and the counselling process
From these beginnings, counselling
expanded rapidly in the latter half of the
twentieth century, in terms of the
membership of counselling professional
bodies, the range, scope and number of
counselling agencies and the ease of public
access to counselling. There would appear to
be a number of factors responsible for this
growth:

The success of the earliest counselling
services, in the areas of education, marital
and bereavement work, inspired groups
of people to develop counselling services
for a wide array of other social issues,
such as suicide prevention, domestic
abuse, sexual violence, drug and alcohol
abuse, disability and affirmation of sexual
orientation.

We live in a fragmented society, in which
there are many people who lack
emotional and social support systems
that might assist them in coping with
stressful problems in living – counselling
fulfils a vital role in society, as a means of
assisting individuals to effectively
negotiate transition points in their lives.

Counselling agencies are generally
located within the communities of those
whom they serve and are networked with
other caring organizations – members of
the public usually know about the
counselling that is available in their
community, and do not feel stigmatized
in making use of it.

Counselling regularly receives publicity in
the media, most of which is positive. The
media image of counselling is low-key
and reassuring, in contrast to, for
example, the cartoon representation of
the psychoanalyst.

The legitimacy of counselling has never
relied on research evidence or
government policy initiatives, but instead
is based on word of mouth
recommendation from users.

Caring and ‘people’ professions, such as
nursing, medicine, teaching and social
work, which had previously performed a
quasi-counselling role, were financially
and managerially squeezed during the
1970s and 1980s. Members of these
professions no longer have time to listen
to their clients. Many of them have
sought training as counsellors and have
created specialist counselling roles within
their organizations, as a way of
preserving the quality of contact with
clients.

Many thousands of people who work in
caring professions have received training
in counselling skills, as part of their basic
professional education, and use these
skills within an ‘embedded counselling’
role. There are also a large number of
part-time volunteer counsellors, who
combine some counselling work
alongside other occupational and family
responsibilities. All this creates an
enormous reservoir of awareness within
society of counselling methods (such as
empathic listening) and values (such as
non-judgemental acceptance).

There is an entrepreneurial spirit in many
counsellors, who will actively sell their
services to new groups of consumers. For
example, any human resource or
occupational health director of a large
company will have a filing cabinet full of
brochures from counsellors and
counselling agencies eager to provide
employee counselling services.

Counselling is a highly diverse activity
which is delivered in a broad range of
contexts (voluntary / not-for-profit,
statutory, private practice, social care,
health, education); this diversity has
allowed counselling to continue to
expand at times when funding pressures
might have resulted in cuts in provision
to any one sector.
The emergence of counselling needs to be
understood in relation to the parallel growth
72
Reading A
of psychotherapy. There have been many
practitioners, from Carl Rogers onwards who
have spanned the counselling-psychotherapy
divide. The majority of counselling agencies
drew heavily on ideas from psychotherapy, to
shape their training, supervision and practice
policies. In the UK, and other countries,
there are organizations, such as the British
Association
for
Counselling
and
Psychotherapy, that seek to emphasize the
convergence of the two professional
traditions and communities. Nevertheless,
counselling has retained its own identity as a
distinctive practice with its own history.
73
74
Reading B
Structuring Work with Clients
Ian Horton
In The Sage Handbook of Counselling and Psychotherapy (3rd ed.)
Colin Feltham and Ian Horton (eds.)
Sage Publications
London, UK, 2012
PGS 122 – 128
75
Study Guide 1: Counselling and the counselling process
STRUCTURING
CLIENTS
WORK
WITH
Preparatory Phase
Many practitioners believe that the
therapeutic relationship actually begins
before any face-to-face contact with clients.
Several factors may influence both the
client’s and the therapist’s expectations of
each other and therefore the beginning of
their relationship and the subsequent
development of the therapeutic process. For
some counsellors or psychotherapists, the
normal procedure may be for a senior
therapist to conduct an intake assessment,
followed by allocation to a suitable therapist
– a process which in itself may structure
expectations and norms.
This chapter examines the structure and
process of counselling and psychotherapy. In
places it overlaps with topics in the following
chapters, but the emphasis here is on
therapeutic phases. The assumption is made
that, irrespective of theoretical orientation, it
is possible to conceptualize the therapeutic
process in terms of framework of broadly
defined phases or stages. Each phase is
characterized by particular process goals or
tasks that need to be achieved as a
prerequisite of moving forward to the next
phase (Beitman, 1990; Egan, 2010; McLeod,
2003). As a structural overview of the
developmental process, the framework
provides therapists with a sense of grounding
and direction. But it is only a cognitive map
and as such cannot reflect the actual
experience or dynamics of a process that
seldom, if ever, follows a straightforward
linear progression through discrete and
clearly defined phases. As the relationship
between therapist and client develops, new
issues may emerge, goals are evaluated and
often redefined, and earlier phase-related
tasks may be revisited and worked on more
deeply. It is a fluid, multidimensional and
complex process.
Prior Knowledge
The therapist may have a referral letter or
report containing detailed information about
the client and her or his presenting problem
and history. Casual comments made by the
receptionist or other people working in the
agency or service setting may unwittingly
influence the therapist’s expectations of the
client.
Clients themselves will often come to therapy
with preconceptions about counselling or
psychotherapy and project them on to the
particular therapist. Previous experience of
some form of psychological or psychiatric
help (a phenomenon that is increasing), or
accounts of the experiences of others, may
similarly influence the client’s expectations.
The client may have heard something about
the reputations of the particular therapist or
agency.
A simple generic model of the four phases of
therapy – preparatory, beginning, middle and
ending – is used here as a heuristic
framework for examining the typical
structure, process and procedures of
counselling and psychotherapy. The
therapist’s own theoretical orientation will
largely determine the relative emphasis and
importance placed on the various aspects of
the
four-phase
model.
Some
psychotherapists regard initial and ongoing
frame management as the main, if not the
only, kind of legitimate structuring (e.g.
Smith, 1991) and many psychoanalytic
therapists are unconcerned with temporal
and outcome issues. On the other hand,
some forms of brief therapy are highly
structured in terms of temporal phase.
Introductory Leaflet
Many agencies or therapists produce
information leaflets to give to potential
clients. The purpose is to inform the client
about the conditions and procedures to
follow and what to expect when coming for
counselling or psychotherapy. The leaflet,
read carefully by some potential clients and
probably ignored by others, is nevertheless an
opportunity to help establish positive and
accurate expectations of what therapy is
about. An information leaflet for clients will
normally contain the following information:
76
Reading B










Letter of Appointment
In some situations the letter offering a first
appointment may be the first contact with the
client, who, even from this limited source of
information, may begin to develop some
impression of the therapist and the service
offered. Therapists may want to convey a
balance of warmth and professional formality
in what and how they write to clients. Letters,
usually typed or neatly handwritten on
headed A4 notepaper, would normally
include the information about the location,
date, time and duration of the first session, as
well as the contact telephone number and, if
appropriate, how and when the client should
confirm acceptance of the appointment.
Some examples of letters to clients can be
found in Chapter 3.8 on ancillary skills in this
volume.
some explanation of what counselling
and/or psychotherapy is about
examples of kinds of problems people
might come with and how therapy can
help
background information about the
particular agency or service offered
qualifications,
experience
and
professional affiliation of the therapists
providing the service
how to make an appointment
fees and how these are paid
cancellation procedures, fee implications
and period of notice required
typical duration and frequency of
sessions and length of contract
theoretical orientation and approach to
counselling or psychotherapy
where the counselling or therapy will take
place, postal address, name and
telephone number of therapist or contact
person.
Preparation Before the Client Arrives
Few if any therapists would disagree that it is
absolutely essential to arrive on time and
before the client arrives. Beginning
practitioners often like to arrive early to
check the room (see Chapter 3.8), read
through the referral report or their case
notes, and maximize their level of ‘free
attention’.
First Telephone Call
Often, the first direct contact between client
and therapist is through a telephone call.
Many people do not find it easy to be a client
and have to admit to others (and to
themselves) that they have a problem they
cannot cope with. Some people agonize for
some time before plucking up enough
courage to make the initial telephone call.
The client may be upset, diffident about
making the call or sceptical about counselling
or psychotherapy. The reception he or she
receives, what the therapist says and how it is
said, may influence the caller’s feelings and
attitudes. The therapist may be very busy or
tired, but if he or she is able to offer a place
for an initial appointment, this is the first
opportunity to start building rapport by
communicating some degree of warmth and
concern perhaps by responding to callers by
mirroring the way they speak. In one sense
the therapeutic relationship starts at this
point. The client needs to feel accepted,
welcomed and understood. What happens
next and what is being offered need to be
explained simply and clearly.
Practitioners vary in their attitude towards
referrers’ reports. Some like to study the
reports carefully, noting issues to explore
with the client or at least to hold as ‘silent
hypotheses’. Some agencies adopt a policy of
asking clients to complete a pre-interview
questionnaire on background history and
personal details. Other practitioners want to
meet the client without being influenced by
the apparent facts and opinions provided by
the referrer. They deliberately do not read the
referral letter until after their first meeting
with the client. The risk with this procedure
is that the referrer might mention some
critical issues which the therapist really does
need to be aware of before meeting the client
– for example, a record of frequent violent or
aggressive behaviour or recent suicide
attempts. The key issue is for the therapist to
be aware of her or his assumptions or
inferences drawn from what can sometimes
77
Study Guide 1: Counselling and the counselling process
be highly subjective and often dated
information about the client.
psychotherapists are seen as powerful people,
and clients initially feeling overwhelmed are
unlikely to correct the therapist’s
pronunciation of their name or the mode of
address and may feel put down or feel that
the therapist does not really care about them
as individuals.
Immediately prior to the expected arrival of
the client, some therapists follow deliberate
procedures to enable them to relax and focus
attention on what they are about to do.
Simple physical relaxation or breathing
exercises or just sitting in silence for a few
minutes can help the therapist to prepare
mentally.
Another concern for some therapists is
whether to leave it to clients to decide where
to sit or, more conventionally, whether to
indicate where the client should sit. To leave
it to the client may, albeit in a small way, helps
the client to feel more equal in an inevitably
unequal relationship, but it can mean that the
client has yet another unfamiliar decision to
make at a time when they are already feeling
anxious about what is going to happen.
Beginning Phase
The first face-to-face meeting with the client
sows the seeds of attraction, uncertainty or
dislike and the beginning of the therapist’s
assessment of the client. People are often
unaware of the source of their feelings or
immediate reactions to others, although
counsellors and therapists are trained to be
aware of the way in which they prematurely
interpret what they notice about the dress
and demeanour of others, or may project
feelings or attitudes derived from previous
relationships or situations on to their clients.
But of course this is a two-way process;
clients will have feelings too and will make
assumptions about the therapist on their first
meeting. Both parties will be tentatively
sizing the other up.
Introduction
‘How can I help you?’, ‘What brings you
here?’, ‘We have 50 minutes together, how
would you like to use the time?’ are some of
the ways in which therapists encourage the
client to start talking as soon as possible.
Some psychoanalytic therapists think it is
important to say nothing from the outset.
However, other practitioners prefer to start
by setting the scene, being aware that once
some clients launch into telling their story it
is hard to stop them, while other more
reticent clients appreciate some time to relax
into their new surroundings with a stranger
and have little or no idea how the therapist
might be able to help them or how to use the
time. There is some ‘collective wisdom’, if
not clear research evidence, that indicates a
strong correlation or association between
therapist and client of the purpose of what
they are doing together and how they are
going to try to achieve it. This shared
understanding is the basis of an effective
working or therapeutic alliance. So some
therapists prefer to start by saying something
like: ‘the purpose of our first meeting today
is for us to get to know each other and for
me to begin to understand something of the
problems or issues that bring you here. At the
end of the hour we may be in a position to
decide whether we want to continue to work
together and we will discuss the necessary
Initial Greeting and Seating
Practitioners vary in the degree of formality
with which they greet their clients. Many do
so warmly, but wait for the client to indicate
tentatively whether they expect to shake
hands. It is important to get the client’s name
correct and it is useful to become familiar
with the naming conventions of different
cultures. If in doubt, it is an idea to ask clients
how they wish to be addressed or at least
initially to adopt a more formal manner of
address, leaving until later the choice to
become more familiar. Some culturally
different names may be difficult for
therapists to pronounce. Again it would be
appropriate for the therapist to ask the client
how to pronounce her or his name. This at
least communicates that it matters to the
therapist to get the client’s name right.
Especially in some cultures, counsellors and
78
Reading B
arrangements.’ Some clients may have been
sent by their GP or persuaded by a friend to
come and may be sceptical about the value of
counselling or psychotherapy. In this
situation the task is to try to establish whether
or not there is a basis for working together
and the therapist may suggest to the client
that they leave it to a subsequent session
before formally contracting to work with the
client. This would give the therapist an
opportunity to consult her or his clinical
supervisor before seeing the client again.
what therapy is about, the rules of therapist
and client, and what is going to happen.
Beginning therapists may find it a very useful
exercise to prepare and rehearse the actual
words they may use to define or explain
counselling or psychotherapy to clients.
The whole idea of therapy as an approach to
problem solving or self-development is
culture bound. Seeking help with
psychological problems from someone
outside the family is alien to some cultures,
and clients may need time to discuss and
assimilate the implications and consequences
of doing so. Similarly, counselling and
psychotherapy goals are culture bound. For
example, concepts such as self-awareness or
self-actualization and the emphasis on
individualism may be inappropriate as
explicitly stated goals when working with
some clients in cross-cultural-settings.
Therapist’s Agenda
Theoretical orientation, personal preference
and style, and agency setting and
organizational constraints or procedures are
some of the factors that may determine the
way in which the first session is structured
and managed. While most therapists tend to
adopt a similar way of working with all their
clients, some vary what they do according to
perceived client needs and expectations. The
style and approach differ enormously
between therapists – even those of the same
orientation – and vary along a continuum
from formal and highly structured to open,
flexible and very much client led.
At some point in the first (few) session(s) it
is usually helpful for the therapist to say
something about the ground rules or
boundaries of counselling or psychotherapy.
Issues about privacy, confidentiality and its
limits, the length of sessions and time
boundaries may need to be explained and
discussed. If the therapist is culturally close
to the client, some clients may feel an instant
rapport and trust, but others may fear a loss
of confidentiality and feel as if they risk what
they say being known by everyone in their
cultural community. The therapist may need
to reassure the client that he or she respects
confidence and that therapy is in no way
compatible with socializing. Some clients
may disclose something critical near the end
of the session, in what feels like the safety of
the session ending; other clients may be
unfamiliar with the strict timekeeping of
middleclass Western practice and be left
feeling resentful when invited by the therapist
or raise the issue again in their next session.
Nevertheless, whether it is explicit or not,
most practitioners will have a similar agenda
for the first few sessions or for the beginning
phase of their work with clients. This agenda
may typically include the following process
goals or tasks, irrespective of whether they
are achieved through listening to the client’s
story, intervening as appropriate as the story
gradually unfolds, or asking questions in a
more structured interview.
Some therapists listen for or deliberately ask
about the client’s expectations and previous
experiences of counselling or psychotherapy.
This information will help the therapist to
assess the client’s needs and level of readiness
and to know how best to begin to facilitate a
strong therapeutic alliance.
Facilitating client self-disclosure is the
primary task of the beginning phase of
therapy. Talking about themselves and their
problems is after all exactly what the client
has come for. The therapist will listen to the
For clients for whom counselling or
psychotherapy is a truly new and unfamiliar
experience, the therapist may need to explain
79
Study Guide 1: Counselling and the counselling process
client’s story and explore the client’s social
and cultural background, history and
experiences, the onset of the problem,
current stresses and issues, coping
behaviours and motivations. This will enable
both the therapist and the client to begin
building a picture of the problem and to
consider if and how therapy might help.
Some therapists start to develop a formal
assessment or clinical formulation of the
client’s present problem and, from this, an
initial therapeutic plan or possible therapeutic
goals and approach to working with the
particular client.
The business contract is important and few
therapists disagree that it needs to be
concrete and explicit. The business contract
concerns such things as the duration,
frequency, number, day and starting time of
sessions, fees and how they are to be paid,
procedures for the cancellation of sessions,
and fees for missed sessions. Some therapists
like to give this information in written form
and include the date and time of the next
appointment.
Comprehensive details of contracting from
the perspectives of different theoretical
orientations are given in Sills (2006).
At this point, usually at the end of the first
session, therapists need to make a decision.
Basically, there are four options:




Ending the first session is an opportunity to
clarify administrative details and handle any
questions the client may still have about the
therapy, before confirming the next
appointment and parting.
to offer counselling or psychotherapy
to offer to refer the client to another
therapist or agency
not to offer counselling or psychotherapy
if the therapist thinks it would be
inappropriate or not useful to the
particular client at this time
to defer the decision to contract until a
later session.
Summary: Beginning Phase Process
Goals
The beginning phase may last for one, 20 or
more sessions depending on the nature of the
contract, the theoretical orientation and the
progress made. The process goals or tasks
that need to be accomplished are
summarized here:
Therapists approach contracting with clients
with varying degrees of formality, clarity and
explicitness (Sills, 2006). It is possible to
identify two types of contracting: therapeutic
and business contracts. The first is concerned
with negotiating and identifying with the
client the sort of desired outcomes the
therapy might achieve, and the initial focus or
aspect of the problem that the therapist and
client intend to work on together and how
they might approach this. The nature of the
therapeutic contract and whether it is stated
explicitly and even written down will depend
very much on the therapist’s theoretical
orientation and personal preference. Some
therapists assume that the therapeutic
contract is part of the client’s induction in to
therapy and a largely unspoken yet integral
part of the gradually evolving therapeutic
process.
80

Build the relationship, establish rapport
and an effective working alliance, clarify
boundaries, conditions and the client’s
role, and work towards developing
mutual aims about the work of therapy.

Facilitate client self-disclosure; identify
the client’s presenting problem through
understanding the client’s worldview and
experiences, exploring antecedents,
precipitating events, social/cultural
context and assessment of client
strengths and resources. The therapist
may begin to develop a tentative
assessment of the nature, origins and
ramifications of the client’s problem(s) in
a way that suggests a possible target for
change. In some psychodynamic work
the early fostering of a positive
transference might be a key task.
Reading B

strengths and ways of coping, working
towards new perspectives, deeper selfawareness or understanding, and learning
different ways of thinking, feeling and/or
behaving.
Negotiate therapeutic and business
contracts, and monitor and review
progress.
Middle Phase
This is typically the longest phase in
counselling or psychotherapy. It is the work
phase in which conflicts and problems are
more clearly defined and worked through. It
is within this phase that the biggest variation
in practice exists. What therapists are trying
to achieve and how they approach the work
are largely determined by their theoretical
orientation and how they explain the origin
and maintenance of psychological problems
and the principles and process of change.
Nevertheless, at least in broad terms, it is
possible to identify the kinds of process goals
or tasks generally associated with this phase.
Therapists vary in how and whether they
explicitly monitor progress. Some formally
contract to hold regular review sessions with
their clients; others rely solely on clinical
supervision, personal reflection and writing
case notes to review progress, while some
believe in suspending the notion of anxiety
about progress altogether.
Reviewing
Some practitioners strongly advocate the
need to include regular review sessions in
their contract with clients, so that every five
weeks or so the client will know that at least
part of the session will be spent reviewing
progress. Other therapists will review only
informally, whenever it seems appropriate or
when something comes up, or alternatively
only when the work has reached an impasse,
when things feel stuck and little, if any,
progress is being made. However, clients are
entitled to a competently delivered service
that is periodically reviewed (BACP, 2002).
Summary: Middle Phase Process Goals
The aspect of the counselling or
psychotherapy process most strongly
associated with successful outcome is the
quality of the therapeutic relationship and
strength of the working alliance. In the
middle phase work continues to maintain and
develop further the relationship between
therapist and client. Where appropriate and
consistent with the therapist’s theoretical
orientation, the dynamics of the relationship,
or what is going on within both therapist and
client and between them, may be used as a
basis for learning and motivation. The
dynamics of the relationship between
therapist and client can often provide a
‘window’ on the client’s presenting problem
and any hidden conflicts or issues.
The arguments for explicitly monitoring
progress with the client include:



In the middle phase the therapist is
concerned with facilitating learning and
change, congruent with the identified
therapeutic goals and theoretical assumptions
about change. It is also the phase in which
sometimes
unexpected
memories,
discoveries, obstacles, crises and ambivalence
or defences may arise. The process goals of
this phase may involve searching for patterns
and key themes in the client’s experiences
and behaviours, affirming and, where
possible and appropriate, using the client’s
to check out the therapist’s assumption
about how things are going and if
necessary use the opportunity to make
changes or improve ways of working
to reinforce learning and change or the
conditions for change
to share power with the client by
involving the client in evaluating progress
and to help re-establish that the therapist
is working with the client rather than for,
or doing something to, the client
Arguments against any formal review
sessions might be that they interrupt the
whole therapeutic process and that any
impasse, stuckness or resistance is better
worked through as a natural part of the
therapy. Review sessions could be seen as a
81
Study Guide 1: Counselling and the counselling process
way of avoiding or even perpetuating
resistance to change and potentially
damaging the transference relationship and
may be misinterpreted by some clients as a
review of them.
Review Session Structure
Review sessions will be conducted with
varying degrees of structure and formality. In
standard
long-term
psychoanalysis
psychotherapy, any form of review may be
discouraged, while some therapists adopt the
practice of asking at each session ‘what the
client wants’, ‘how it went’, etc. however, a
full review agenda would usually involve
discussing the following aspects:







Client and therapist expectations and
understanding of what it is they are trying
to achieve together.
Therapeutic goals: what has been
achieved? What changes have occurred?
What evidence is there of any change?
Client’s experience of the therapeutic
process and relationship: what has the
client found helpful, unhelpful or
difficult? What problems, if any, do the
therapist and client have in working
together?
Negotiate ways forward. Review and
confirm, and if necessary, revise the
therapeutic goals or focus of the work,
and discuss possible alternative ways of
working.
Review the business contract, and
recontract for a further period before the
next review session.

For some clients, separation and loss may
have been a key theme or conflict in their
work with the therapist. Ending therapy may
mean a reworking of earlier loss or
celebration of a new beginning. Ending may
be more critical in some types of time-limited
contracts and therapists need to pay attention
to managing effectively client resources and
deficits.
Summary: Ending Phase Process Goals
Most therapists will pay attention to some or
all of the following tasks in working towards
a satisfactory ending with their clients:
Ending Phase

The ending phase of therapy may represent a
real or symbolic loss for many clients. It can
provide a potent force in changing a client’s
frame of mind. In thinking about how best to
orchestrate endings or the termination of
counselling or psychotherapy, therapists will
need to have views, although not necessarily
clearly articulated views, on several issues
(Davis, 2008; Leigh, 1998):

to prepare for the ending? Some
therapists discuss the ending at the
beginning of their work with clients;
others use a ‘countdown’ system to
remind clients about how many sessions
they have had and how many remain.
Who decides when therapy should end?
Is it decided by the client, by the therapist
or by mutual agreement?
How rigid is the decision about ending?
Will the therapist adhere strictly to the
agreed ending date? This decision is
usually linked to the nature of the
therapeutic goals, type of contract and
sometimes negotiated or otherwise
implicit completion criteria. Clearly,
therapists need to be aware of what, if
any, are the circumstances that justify an
extension and how flexible they can be
and what the ramifications are.
What may be the special existential or
development needs of the particular
client around loss and ending?


How explicit is the issue of ending
therapy with clients? How important is it
82
seeking resolution of the client’s issues
around ending
exploring ways of consolidating learning
and change through helping clients to
apply and assimilate change into new
ways of being or living and through
identifying obstacles and ways of
sustaining and expanding change
evaluating the outcomes of therapy and
the effectiveness (or otherwise) of the
therapeutic process and relationship
Reading B
A high percentage of counselling and
psychotherapy contracts end by default
rather than by design. That is, clients may just
stop coming for therapy, sometimes not even
letting the therapist know and not replying to
the therapist’s letter. Incomplete ending by
default can haunt therapists for some time. It
is all too easy to slip into imagining all sorts
of circumstances or reasons, including the
therapist’s own mistakes or incompetence,
for clients failing to attend to the end of the
negotiated contract or agreed period of
therapy. These things are best worked
through in clinical supervision. However,
most therapists will have the opportunity to
formally complete their ending work with a
client.

Ending Session Structure
Ending can be viewed as a process in itself.
The aim is to help clients integrate their views
of what has happened and reinforce the
positive aspects of the experience. The
intention is to enable clients to sustain any
change.
There are five areas that can be usefully
explored with clients at the end of
counselling or psychotherapy:




What has been achieved? What changes have
occurred or are anticipated by both client
and therapist? Were the goals met?
What still needs to be achieved? Is it possible
to anticipate any return of symptoms in
particular circumstances? Will the client
be able to cope with old problems using
the new ‘solutions’ or ways of coping
learned in therapy?
Why has change happened? How does the
client attribute cause or responsibility for
change? The client’s story about therapy
is the best predictor of whether useful
changes will last. Clients need to know
the ways that they contributed to or are
responsible for any change and the
quality of the relationship.
What may happen in the future? Is it possible
to anticipate any stresses or ‘rough
spots’? What resources are available for
support? Sometimes it is helpful to try to
83
identify signs or indicators of the need to
start therapy again. Will the therapist
offer a one-off follow-up in say six to
eight weeks, or invite the client to make
contact again if necessary? What possible
messages might that give to the client?
What seems important is that a ‘good
ending’ will help to ensure that clients will
have positive feelings about the prospect
of returning to therapy – and see it not as
a failure, but as a normal occurrence in
developmental change.
What has been the nature of the therapy
relationship? This can be threatening to the
therapist, and some see it as irrelevant to
identifying what qualities were helpful
and/or difficult in the relationship. The
client may be encouraged to identify what
has been learned from the therapy
relationship that may help the client in
other relationships.
Study Guide 1: Counselling and the counselling process
84
Reading C
Learning Counseling and Problem-Solving Skills
Leslie E. Borck and Stephen B. Fawcett
Routledge
New York, NY, 2013
PART I: PGS 61 – 68
PART II: PGS 70 – 75
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Study Guide 1: Counselling and the counselling process
PART I:
HOW TO HELP A CLIENT SOLVE
A PROBLEM
CLIENT: My son has no friends in school.
HELPER: Uh-huh.
CLIENT: I tried talking to his teacher about
it, but that didn’t do any good. (Sighs and
pauses)
Clients and friends come to a helper because
they are having a problem. Sometimes they
simply need to talk about the problem
situation. In these cases, the counselor’s
responsibility is to be a good listener and help
the client ventilate his or her feelings. The
skills of listening actively, reflecting feelings,
and open-ended question-asking will be very
effective in helping a person do this.
HELPER: You sound very depressed about
the whole thing.
CLIENT: I am.
HELPER: Could you tell me more about it?
CLIENT: Sure. He’s in the fourth grade, and
has no friends. He’s very quiet anyway,
but I understand he says very little in
school. At home he has his sister and
brothers to play with, but I’m worried
because he is always by himself at school.
At other times, people need help solving a
problem. In these cases, the counselor’s
responsibility is to help the client understand
the problem situation, think of alternative
solutions, evaluate each, and select the best
one.
HELPER: Uh-huh.
CLIENT: I don’t know if it has gotten worse
or anything. I just think he’s getting to the
age where he needs to have friends his
own age. I mean, other children all play
with children their own age, don’t they?
This chapter is designed to teach problemsolving skills that enable helpers to assist
clients in reaching satisfactory decisions. It is
important that the counselor assist the client in
solving problems, not solve problems for the
client. By demonstrating a systematic
problem-solving approach, the helper
provides an example of how the client might
solve his or her problems in the future.
HELPER: Sounds like you’re worried that the
problem might get worse if you don’t do
something about it soon.
CLIENT: Right. I probably should have done
something about it a long time ago.
HELPER: It seems like you have some
feelings about that.
Address the client by name throughout the
problem-solving process. This helps to
encourage the client to be honest and open.
CLIENT: I do, but that gets into a whole
different story.
When to Use
HELPER: Would you like to talk about it?
Use the systematic problem-solving approach
in the following situations:



CLIENT: Someday, but not now.
HELPER: So the problem seems to be that
your son doesn’t have any friends his
own age. Is that right?
The client requests help in solving a
problem.
The client requests help in choosing
solutions to a problem.
The client requests help in taking action
on a selected plan.
CLIENT: Yes.
HELPER: Kay, let’s look at all the ways we
can think of to help you get your son
more involved with children his own age.
Most people find it useful to think of as
many alternatives as they can before
making a decision.
Here is an example of a counselor helping a
client solve a problem.
HELPER: What seems to be the problem,
Kay?
CLIENT: Okay.
86
Reading C
HELPER: What ideas do you have? I’m going
to write them all down so we don’t forget
any.
HELPER: How about talking with the school
psychologist? She might have experience
with this kind of problem. I’ll add it to the
list. Kay, let’s look at each one and think
what might happen if you were to do it.
What do you think would happen if you
talked to your son’s teacher again?
CLIENT: Okay. I’ve been thinking about
going in and talking to his teacher again.
I’ve talked to him once, but it was a long
time ago. It didn’t do any good then, but
it might be better if I talked with him
again.
CLIENT: Probably nothing.
HELPER: I see.
HELPER: That’s an idea.
CLIENT: He’s pretty strict with his students,
and doesn’t have much sympathy for
children who are having problems. Last
time I talked to him, he said children’s
problems are all caused by their parents.
Maybe that’s true, but it didn’t help me
out at all.
CLIENT: I’ve already tried talking to my son
about it, but he doesn’t want to talk about
it at all.
HELPER: So, Kay, another alternative might
be trying to talk to him again?
CLIENT: Anything is worth a try at this
point.
HELPER: I can understand that.
CLIENT: Anyway, I don’t expect it to help,
but maybe talking to him again would be
worth a try.
HELPER: Can you think of any other things
you can do?
CLIENT: Um…
HELPER: One thing that might come out of
it is letting him know you are really
concerned about your son. That might
make him listen to you more.
HELPER: Have you thought about your
husband, son, and yourself talking to a
professional counselor about the
problem?
CLIENT: Never thought of that. Could be,
but with him, I don’t know.
CLIENT: No. That might be a good idea. I
hadn’t thought of that.
HELPER: So, Kay, how would you rate this
idea? Excellent? Fair? Poor?
HELPER: Let’s see. What else could you do?
CLIENT: I could always just keep waiting and
hoping it’s only a phase. That’s really
what I’ve been doing, you know.
CLIENT: Oh, I’d say fair.
HELPER: Okay. What about talking to your
son? How does that alternative sound?
HELPER: Uh-huh. Can you think of any
other things to do?
CLIENT: That’s the worst on the list. Believe
me, I’ve tried. He won’t talk, gets very
angry when I bring the subject up, and we
usually end up yelling at each other,
which defeats the whole purpose.
CLIENT: No.
HELPER: (Pauses) Let me think. (Pauses) I
can’t either. Kay, let me read back the
alternatives we’ve thought of. You could
try talking to your son’s teacher again.
You could talk to you son. We thought of
your husband, son, and you talking to a
professional counselor. We also thought
of just waiting and hoping the problem
passes with time. Can you think of any
more?
HELPER: Doesn’t sound like you feel that’s
a promising avenue to take.
CLIENT: No, I don’t.
HELPER: How would you rate it, excellent,
fair, or poor?
CLIENT: Oh, rate that one as poor.
HELPER: What might happen if you all went
to a professional counselor for help?
CLIENT: No. The list sounds pretty
complete.
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Study Guide 1: Counselling and the counselling process
CLIENT: I think it would do us all good.
CLIENT: I know. It might help, but I’d rather
get professional help outside of the
school.
HELPER: I see.
CLIENT: I know it would do me good.
HELPER: I keep noticing that you favor the
professional counselor.
HELPER: Uh-huh.
CLIENT: I like that idea.
CLIENT: I am, and there’s another reason,
too. My husband and I are in
disagreement about what to do about our
son. I think we could use the help of a
counselor ourselves.
HELPER: What are you imagining would
come from it?
CLIENT: Well, we could get everything out
in the open. My son won’t talk to me, but
maybe he’d talk to a counselor about
what’s been going on with him.
HELPER: You sound pretty positive about
things working out alright.
CLIENT: Talking about them now is making
me realize that I really am. I think my
husband and I need to get some things
squared away between ourselves, and I
know that we’ll be able to do that.
HELPER: Uh-huh. You sound more positive
about this idea.
CLIENT: I am.
HELPER: Professional counseling may cost
you something.
HELPER: Where would you rate the school
psychologist idea?
CLIENT: It would be well worth it if it
helped.
CLIENT: Between excellent and fair.
HELPER: Are there any other outcomes you
can think of?
HELPER: We also listed just waiting. How do
you feel about that alternative?
CLIENT: No.
CLIENT: It’s out of the question. I can’t
afford to wait anymore.
HELPER: How would you rate this idea?
HELPER: Here’s the list, Kay, and the way
you rated each alternative. Which sounds
the best?
CLIENT: Excellent.
HELPER: What about talking to the school
psychologist?
CLIENT: The professional counselor. I like
that idea, and I think it’s going to help.
CLIENT: Not as good. It could help, but then
again, if my son found out, he’d be mad
because he’s told me to leave him alone
about it.
HELPER: Sounds good, huh?
CLIENT: Yes.
HELPER: What are your feelings about that,
Kay?
HELPER: Sounds good to me, too. Do you
have any further questions about how to
find a counselor?
CLIENT: Well, he doesn’t talk that often, so
when he says something, I try to respect
it. I’d hate to embarrass him in front of
his peers. That could end up making him
even more withdrawn and alone. You
know how kids are.
CLIENT: No. I’m sure my friends can
recommend someone.
HELPER: Please let me know how things
work out.
CLIENT: I will. This has been so helpful.
Thank you.
HELPER: Yeah, I do. One possible
advantage, though, is that you might get
some ideas from the school psychologist
because she may have been able to
observe your son in school.
88
Reading C
We recommend a series of activities to help a
client solve a problem. Each is described
below; all fourteen are listed in the summary
at the end of this chapter.
Writing the problem down can serve several
purposes. For one, it will allow you to list the
alternatives suggested during the problemsolving process. This will help you remember
all the alternatives mentioned and will help
you sum up when closing the helping session.
It will also be useful if the client requests
further help. The written information will
refresh your memory of an earlier meeting
with the client.
Request a Problem Statement
You should request a problem statement by
asking an open-ended question. The question
should be followed by a pause of at least five
seconds.
Use two sheets of paper with carbon paper
between them. This way you can file one copy
for yourself and you can give one copy to the
client. One way to set up the paper is in a
problem-solving worksheet (see Figure 3)
It is sometimes the case that the client will
state the problem without the counselor
requesting a problem statement. Some clients
begin speaking about their problems without
any specific request from the counselor. If this
occurs, go to the next step, which is to define
the problem.
Here are two ways to request a problem
statement and define the problem:
Define the Problem
Example 1
HELPER: What seems to be the problem?
You should repeat the problem statement
either in your own words or in the client’s.
Use a close-ended question to make sure of
your understanding of the problem. Wait in
silence for the client to confirm or dispute
your definition of the problem. If the client
partially confirms or disputes your definition
of the problem, ask the client for another
problem statement, and attempt once again to
define the problem. When the client confirms
your definition, you may want to write the
problem down on a sheet of paper.
CLIENT: I’m totally out of money because I
haven’t been able to find a job in the past
five months.
HELPER: So it seems the problem is that you
need a job soon or some money to hold
you over until you can find one. Is that
right?
CLIENT: Yep, that’s it.
Example 2
HELPER: How would you describe the
problem?
Waiting for a confirmation is a way to make
sure you and the client are talking about the
same thing. It also gives your client an
opportunity to add or clarify something so
that you can have a fuller picture of the
problem situation.
CLIENT: My father is getting pretty old. He
forgets things and is barely able to take
care of himself anymore. He is living by
Figure 3. Headings for a Problem-Solving Worksheet
Client’s Name:
Date:
Counselor’s Name:
Problem:
Alternatives:
89
Study Guide 1: Counselling and the counselling process
himself, and that worries me. I don’t
know what to do.
thinks of, regardless of how they may sound
at first. It can be helpful to tell the client that
by looking at the possible positive and
negative outcomes of each alternative, he or
she should be able to make the best decision.
You may also want to explain why you are
writing down the alternatives mentioned.
HELPER: Let me make sure I’m clear. The
problem is that your father is getting old
and can’t take care of himself anymore. Is
that correct?
CLIENT: Yes, and I don’t think he can come
live with me.
State the Usefulness of the
Problem-Solving Process
Here is one way to request a problem
statement and define the problem after a
client rejects the helper’s problem statement.
Notice how the helper attempts to define the
problem again:
Example
HELPER: What seems to be the problem?
After explaining the problem-solving process,
you should tell the client that the process will
be useful. You might also want to say that
upon completion of the problem-solving
process, the client may be able to make future
decisions on his or her own using this
systematic process.
CLIENT: I’m totally out of money because I
haven’t been able to find a job in the past
five months.
Examples of how to explain the problemsolving process and its usefulness to a client
are:
HELPER: I imagine that must be creating a
problem between you and your wife.

“We’re going to figure out as many ways
of solving your problem as we can. The
best way to make a good decision is to
look at each possible solution and figure
out its consequences. Let’s think of all the
solutions we can, regardless of whether
they sound good or bad. I’m going to
write everything down so we don’t forget
any of them. It should be a very useful
process for helping you solve your
problem.”

“We’re going to use a systematic approach
to problem solving. It involves thinking of
all possible alternatives for solving your
problem, regardless of how good or bad
they sound. I’ll write them down. We’ll
look at the pros and cons of each, and you
should be able to decide on a way to solve
your problem. By going through this
process with me, it may make it easier to
solve a future problem on your own.”
CLIENT: No, my wife is very understanding.
HELPER: What is the problem then?
CLIENT: I’m getting very depressed from
having nothing to do. I need to find a job.
HELPER: So, you’re needing some help in
finding a job, is that right?
CLIENT: Yeah, that’s right.
The outcome is a list of one or more problem
statements. Write only one statement per
sheet of paper. Clients may need help with
more than one problem. We recommend that
you assist a client in solving one problem at a
time.
Explain
Process
the
Problem-Solving
You should explain to the client how you will
be helping to solve his or her problem.
Provide a rationale for using this process. You
might say that you and the client will be
thinking of possible ways to solve the
problem. You might want to encourage the
client to tell you any alternatives he or she
An explanation of the problem-solving
process will give a client an overview of what
will follow. It can help make a client feel more
relaxed. It also can make the problem-solving
process go faster because the client knows
90
Reading C
beforehand what you will do and what will be
expected.
Examples of how to introduce this method
are:
Stating the usefulness of the problem-solving
process can give encouragement to a client
who may feel that there is no solution to his
or her problem.


Identify Alternative Solutions
“Let’s see what alternatives we can think
of. What ideas do you have?”
“Let’s list all of the possibilities to solving
the problem that we can. What are some
you can think of?”
One cannot, at this point, determine which
alternative will turn out to be best for the
client. You must encourage the client to
mention any idea at all, regardless of how
unlikely it may sound. This is the time to think
of as many solutions as possible. Sometimes
the most farfetched ideas turn out to be the
best. A client will often feel much better
knowing that many possible solutions exist.
Don’t make negative or positive evaluations
of any alternative at this point. Your neutrality
may encourage the client to feel freer to voice
any idea. In reality, a counselor does not know
the consequences an alternative may have in a
client’s life. If you were to offer your opinion
of an alternative at this point, a client might
begin to feel that you are pushing your ideas
without fully understanding his or her
situation.
To identify alternative solutions, first ask a
client to tell you all the possible solutions he
or she can think of to the problem. Write
these down. No possible solutions should be
excluded. Second, ask open-ended questions
to encourage the client to consider any
solutions that you suggest. You may want to
use the Problem Solving Index in Part III of
this book for additional ideas.
You might introduce your ideas with openended phrases, such as, “Have you thought
about…?” or “What about…?” It is best not
to suggest your alternatives by saying, “You
should do…,” or “You ought to…” Effective
helpers neither argue for their own
suggestions nor evaluate negatively or
positively those of the client. Take special care
not to play with you pen during the helping
session, lest you seem bored or impatient.
Also, take care not to talk as you write,
because it is difficult to concentrate on either
when you do both together.
Write down all the alternatives that both of
you mention. Figure 4 is an example of a
partially
completed
problem-solving
worksheet.
Figure 4. Partially Completed Problem-Solving Worksheet
Client’s Name:
Susan Singer
Date:
February 26, 1980
Counselor’s Name: Kathy Langer
Problem: Gets lonely
Alternatives:
1. Join club in school to meet new people
2. Join church youth group to meet new people
3. Talk to new person in class
4. Talk to professional counselor
5. Join sports team
6. Find satisfying hobby you can do by yourself
7. Make plans to do things with friends
8. Do things with your family
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Study Guide 1: Counselling and the counselling process
PART II:
Summarize
Mentioned
the
Analyze
the
Consequences
Alternative
Alternatives
You should make a summarizing statement.
Include all the alternatives you and the client
have mentioned. You can do this by reading
the list of alternatives you have written down.
Remember to ask the client if there are any
other alternatives not yet mentioned.
You should introduce the next phase of the
problem-solving process by telling the client
that analyzing the consequences of each
alternative will help him or her to make the
best decision. Ask the client to state all
possible outcomes for each listed alternative.
You should also state any consequence you
can think of, even if it probably doesn’t apply
to the client’s situation. You may want to use
the Index in Part III for additional ideas. No
consequence should be excluded.
Here is an example of a counselor
summarizing the alternatives identified:

Possible
of
Each
“Let’s go over the alternatives we’ve
thought of. You can join clubs in school
or join your church youth group to meet
new people, talk to a new person in class,
talk to a professional counselor for more
help, join a sports team, find a hobby
you’d like to do by yourself, make plans to
do things with friends, or do things with
your family. Can you think of any more?”
The analysis of possible consequences should
include a consideration of the following
things:
1. benefits gained for the client and others,
2. problems caused for the client and others,
3. feelings that could be aroused for the
client and others,
4. availability of the alternative,
5. any entrance requirements; that is
conditions that may have to precede the
alternative.
Turn the Worksheet toward the
Client
Turn the paper on which the alternatives are
listed toward the client so that he or she may
easily read through the list. You might want to
ask if there are any other solutions that should
be added to the list.
It can be helpful to ask the client a specific
question about each of these five
considerations for each alternative before
considering the next one.
As with all summarizing statements,
summarizing the alternatives identified
provides an opportunity for the client or
helper to make additional comments. It
signals the client that you both are ready to
move on to the next phase of the process.
Some examples of how to ask a client to
consider the consequences of each alternative
are as follows:

People often find it useful to read the list
because it makes it easier to remember the
alternatives mentioned. Sharing the list with
the client can help the client remain active in
the problem-solving process. Remember
good counselors help a client solve a problem;
they don’t solve the problem for a client.



“What do you think would happen if you
choose this one?”
“What outcomes would be likely if you
decided to do this?”
“How do you feel about this idea?”
“What are the advantages of this one?
What are the disadvantages?”
Since the consequences of any solution affect
the client’s level of satisfaction, the careful
analysis of each alternative is an important
aspect of problem solving.
92
Reading C
Note: Clients often express many feelings
(both verbally and nonverbally) while
analyzing the positive and negative
consequences of each alternative. Try to make
reflecting statements when you observe these
feelings.
CLIENT: The main one is that I’ll have to
find some way to support myself if I give
up my job to go back to school.
HELPER: Yep. What other disadvantages
might there be?
CLIENT: Well, what happens if I’ve
forgotten how to study?
Here is an example of a client and helper
analyzing the consequences of one alternative.
Note how the helper reflects the client’s
feelings. Also note the open-ended style that
introduces the consequences the helper
mentions.
HELPER: You seem to be concerned about
that.
CLIENT: I am. It’s probably why I’ve never
enrolled in school again.
HELPER: (Makes nonverbal encouragements)
HELPER: Let’s look at the advantages and
disadvantages of each alternative. That
should help you make the best decision
about what to do. The first one is going
back to school. How do you think you
might benefit from doing that?
CLIENT: I’ve had many people tell me not to
worry about it, but I guess I do.
HELPER: It sounds like it’s the main reason
you have for not going back to school.
CLIENT: I guess it’s really the only reason.
CLIENT: Well, I could probably get a better
job after I finish.
HELPER: Are there other disadvantages to
going back to school except perhaps
having difficulty with the studying?
HELPER: Uh-huh. What other advantages
might there be?
CLIENT: Not really.
CLIENT: I know I would enjoy being back in
school.
HELPER: Have you considered whether or
not you can get into the program?
HELPER: You sound like that’s an exciting
thought.
CLIENT: Ah, thanks for reminding me about
that. I’d really like to return to school, and
sometimes I forget that I still have to be
accepted.
CLIENT: It is. I’ve often thought about
wanting to return to school. I liked being
in school.
HELPER: (Nods head) What else do you think
might happen if you go back to school?
HELPER: What other benefits might there
be?
CLIENT: Really, nothing bad.
CLIENT: Just mostly being able to get a
better job.
HELPER: I can’t think of anything else.
HELPER: Have you thought about the fact
that going back to school may give you a
way to meet a whole new group of people?
Carefully analyzing each alternative in this way
will help a client choose the best plan of
action. Questioning a client about the
advantages, disadvantages, availability, and
any entrance requirements helps to ensure
that a chosen alternative is feasible and
satisfactory. Making comments or asking
questions about a client’s feelings toward an
alternative helps to bring into the open any
concerns he or she may have toward a
possible course of action. You will then be in
a better position to help the client deal with
his or her concerns.
CLIENT: That’s true. I think that’s partly why
I’ve been wanting to go back to school.
HELPER: Can you think of any more benefits
of going back to school?
CLIENT: No.
HELPER: I can’t either. What problems
might be caused by it?
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Study Guide 1: Counselling and the counselling process
Rate Each Alternative
alternatives on the basis of the ratings and
your discussion.
After analyzing the consequences of one
alternative, ask a question to determine how
satisfactory the client finds that alternative.
Use a rating scale, such as excellent, fair, or
poor, and write down the client’s rating next
to each alternative.
An example of asking the client to select the
best alternative or alternatives is as follows:

Two examples of how to ask a client to rate
his or her satisfaction with an alternative are
as follows:


“Here is the list of alternatives. Based on
your ratings and all we’ve talked about,
which one sound best?”
Determine Client’s Satisfaction
with Choice
“If you were to label this alternative, what
would you call it: excellent, fair, or poor?”
“How good does this alternative sound?
Would you rate it excellent, fair or poor?”
You should ask an open-ended question to
determine if the client is satisfied with his or
her selected alternative(s).
If the Client is Satisfied with the
Choice, State Your Support for
the Decision
Writing the rating next to the alternative on
the counselor’s list will allow a client and
counselor to look at the list and see how each
alternative is rated in comparison with the
others. This will make it easier for a client to
see which alternatives he or she favors.
You should tell the client you think the
decision is a good one.
Ask if Help is Needed to Take
Action
Select the Best Alternative
After every alternative is analyzed and rated,
give the list of rated alternatives to the client.
Ask the client to select the best alternative or
You should ask a close-ended question to
determine if the client knows how to carry out
the chosen alternative(s).
Figure 5. Completed Problem-Solving Worksheet
Client’s Name:
Susan Singer
Date:
Counselor’s Name:
Problem: Gets lonely
Alternatives:
1. Join club in school to meet new people
2. Join church youth group to meet new people
3. Talk to new person in class
4. Talk to professional counselor
5. Join sports team
Excellent
X
Fair
Poor
X
X
X
X
6. Find satisfying hobby you can do by yourself
7. Make plans to do things with friends
8. Do things with your family
February 26, 1980
Kathy Langer
X
X
X
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Reading C
When the client has said he or she is satisfied
with the choice, you may follow this example
of stating your support for the decision and
of asking if help is needed to take action:

CLIENT: I don’t think so at this time.
HELPER: So, it sounds like you think that
calling a lawyer is the next thing to do,
and then you will think about where to
live. Anything else?
“Carol, you decided that a trial separation
from your husband would be the best
idea. That sounds like a good idea to me,
too. Do you have any questions about
how to arrange for the separation?”
CLIENT: No. That’s enough.
If the Client Is Not Satisfied
with the Choice, Try to Identify
More Alternatives
If It Is Needed, Provide Help in
Taking Action
You can do this by asking the client if he or
she can make any other suggestions. Analyze
the consequences of each of these new
alternatives, and ask the client to rate each
one.
This can be done by suggesting ways of
taking action. Ask the client if he or she can
think of any others. You may want to write
the suggestions down. Make a summarizing
statement of the ideas mentioned, and ask a
closed-ended question to determine the
client’s satisfaction with the choice.
Select the Best Alternative
Give the complete list of rated alternatives to
the client, and ask him or her to select the
best one.
Here is an example of asking if help is needed
in taking action and in providing that help:
When the client chooses an alternative, the
counselor should then ask if help is needed
to take action and, if it is, provide help.
HELPER: Carol, you decided that trial
separation from your husband would be
the best idea. That sounds like a good idea
to me, too. Do you have any questions
about how to arrange it?
Note: There may be times when a client
chooses an alternative solution that is
incompatible with the values of the helper,
for example, using violence or illegal or
immoral acts to solve a problem. If this
occurs, you need not state support for the
client’s decision nor provide help in taking
action. If the client does threaten to do
something illegal, you should consult your
supervisor or, if you have no supervisor, a
municipal agency head or the police.
CLIENT: Yes. How do I go about doing it?
HELPER: Let’s see what ways we can think
of. How about calling your family lawyer
and finding out what legal issues are
involved?
CLIENT: That’s a good idea. I think I’ll call
my friend and use her lawyer, though.
HELPER: What other concerns do you
have?
CLIENT: I guess I have to think about where
I will live?
The problem-solving process outlined above
is followed for one problem at a time. If a
client has identified more than one problem,
repeat all of the activities for each problem.
HELPER: Do you need help finding a place
to live?
Summary
CLIENT: Gee, thanks. I think I can take care
of that.
In summary, the steps in problem-solving are
as follows:
HELPER: Are there other things you need
help with?
1. Request a problem statement.
2. Define the problem.
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Study Guide 1: Counselling and the counselling process
3. Explain the problem-solving process.
4. State the usefulness of the problemsolving process.
5. Identify alternative solutions.
6. Summarize the alternative identified.
7. Turn the list over to the client.
8. Analyze the possible consequences for
each alternative.
9. Rate each alternative.
10. Select the best alternative.
11. Determine client’s satisfaction with
choice.
If the client is satisfied with the choice:
12. State your support for the decision.
13. Ask if help is needed to take action.
14. Provide help in action if needed.
If the client is not satisfied with the choice:
12. Try to identify more alternatives.
13. Select the best alternative.
14. Ask if help is needed to take action.
15. Provide help in taking action if needed.
96
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Study Guide 1: Counselling and the counselling process
98
Reading D
Direct Social Work Practice: Theory and Skills (9th ed.)
Dean H. Hepworth, Ronald H. Rooney, Glenda Dewberry-Rooney, and Kimberly
Strom-Gottfried
Brooks/Cole
Belmont, CA, 2013
PGS 47– 50
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Study Guide 1: Counselling and the counselling process
Establishing Rapport
people, especially those who have difficulty
confiding in others.
Before starting to explore client’s difficulties,
it is important to establish rapport. Rapport
with clients fosters open and free
communication, which is the hallmark of
effective interviews. Achieving rapport
enables clients to gain trust in the helpful
intent and goodwill of the social worker, such
that they will be willing to risk revealing
personal and sometimes painful feelings and
information. Some clients readily achieve trust
and confidence in a social worker, particularly
when they have the capacity to form
relationships easily. Voluntary clients often
ask, “Who am I and why am I in this
situation?”; involuntary clients have less
reason to be initially trusting and ask, “Who
are you and when will you leave?” (R. H.
Rooney, 2009).
Cultural factors and language differences
compound potential barriers to rapport even
further. For example, some Asian Americans
and persons of other ethnic groups who retain
strong ties to cultural traditions have been
conditioned not to discuss personal or family
problems with outsiders. Revealing problems
to others may be perceived as a reflection of
personal inadequacy and as a stigma upon the
entire family. The resultant fear of shame may
impede the development of rapport with
clients from this ethnic group (Kumabe,
Nishida, & Hepworth, 1985; Lum, 1996; Tsui
& Schultz, 1985). Some African Americans,
Native Americans, and Latinos may also
experience difficulty in developing rapport
because of distrust that derives from a history
of being exploited or discriminated against by
other ethnic groups (Longres, 1991; Proctor
& Davis, 1994).
Establishing rapport begins by greeting the
client(s) warmly and introducing yourself. If
the client system is a family, you should
introduce yourself to each family member. In
making introductions and addressing clients,
it is important to extend the courtesy of asking
clients how they prefer to be addressed; doing
so conveys your respect and desire to use the
title they prefer. Although some clients prefer
the informality involved in using first names,
social workers should be discreet in using
first-name introductions with all clients
because of their diverse ethnic and social
backgrounds. For example, some adult
African Americans and members of other
groups may interpret being addressed by their
first name as indicative of a lack of respect
(Edwards, 1982; McNeely & Badami, 1984).
Children may be unfamiliar with having
conversational exchanges with unfamiliar
adults (Lamb & Brown, 2006). For example,
their exchanges with teachers may be
primarily directive or a test of their
knowledge. Asking them to describe events or
family situations may be a new experience for
them, and they may look for cues from the
accompanying adult about how to proceed.
Open-ended questions are advised to avoid
providing leading questions.
Clients’ difficulties in communicating openly
tend to be exacerbated when their problems
involved allegations of socially unacceptable
behavior, such as child abuse, moral
infractions, or criminal behaviour. In groups,
the pain is further compounded by having to
expose one’s difficulties to other group
members, especially in early sessions when the
reactions of other members represent the
threat of the unknown.
With many clients, social workers must
surmount formidable barriers before
establishing rapport. Bear in mind that the
majority of clients have had little or no
experience with social work agencies and
enter initial interviews or group sessions with
uncertainty and apprehension. Many did not
seek help initially; they may view having to
seek assistance with their problems as
evidence of failure, weakness, or inadequacy.
Moreover, revealing personal problems is
embarrassing and even humiliating for some
One means of fostering rapport with clients is
to employ a “warm-up” period. This is
particularly important with some ethnic
minority clients for whom such openings are
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Reading D
cultural norm, including Native Americans,
persons with strong roots in the cultures of
Asia and the Pacific Basin, and Latinos.
Aguilar (1972), for example, has stressed the
importance of warm-up periods in work with
Mexican Americans. Many Native Hawaiians
and Samoans also expect to begin new
contacts with outside persons by engaging in
“talk story,” which involves warm, informal,
and light personal conversation similar to that
described by Aguilar. To plunge into a
discussion of serious problems without a
period of talk story would be regarded by
members of these cultural groups as rude and
intrusive. Social workers who neglect to
engage in a warm-up period are likely to
encounter passive-resistant behavior from
members of these cultural groups. A warm-up
period and a generally slower tempo are also
critically important with many Native
American clients (Hull, 1982). Palmer and
Pablo (1978) suggest that social workers who
are most successful with Native Americans
are low-key, nondirective individuals.
Similarly, increased self-disclosure is reported
by Hispanic practitioners as a useful part of
developing rapport with Hispanic clients
(Rosenthal-Gelman, 2004).
and a brief discussion of a timely topic
(unusual weather, a widely discussed local or
national event, or a topic of known interest to
the client) will adequately foster a climate
conducive to exploring clients’ concerns.
Most clients, in fact, expect to immediately
plunge into discussion of their problems, and
their anxiety level may grow if social workers
delay getting to the business at hand (Ivanoff,
Blythe, & Tripodi, 1994). This is particularly
true with involuntary clients who did not seek
the contact. With these clients, rapport often
develops rapidly if social workers respond
sensitively to their feelings and skillfully give
direction to the process of exploration by
sharing the circumstances of the referral,
thereby, defusing the threat sensed by such
clients. Tuning in to their feelings and
explaining what they can expect in terms of
their role and that of the social worker goes a
long way toward reducing these tensions (see
Chapter 5).
Respect for clients is critical to establishing
rapport and we stress the importance of
respecting clients’ dignity and worth,
uniqueness, capacities to solve problems, and
other factors. An additional aspect of showing
respect is demonstrating common courtesy.
Being punctual, attending to the client’s
comfort, listening attentively, remembering
the client’s name, and assisting a client who
has limited mobility coveys the message that
the social worker values the client and esteems
his or her dignity and worth. Courtesy should
never be taken lightly.
Warm-up periods are also important in
establishing rapport with adolescents, many
of whom are in a stage of emancipating
themselves from adults. Consequently, they
may be wary of social workers. This is
especially true of individuals who are
delinquent or are otherwise openly rebelling
against authority. Moreover, adolescents who
have had little or no experience with social
workers have an extremely limited grasp of
their roles. Many adolescents, at least initially,
are involuntary clients and perceive social
workers as adversaries, fearing that their role
is to punish or to exercise power over them.
The judgment of how much warm-up is
necessary and how much is too much is a
matter of art and experience with initially
reluctant potential clients….
Verbal and nonverbal messages from social
workers that convey understanding and
acceptance of clients’ feelings and views also
facilitate the developing of rapport. This does
not mean agreeing with or condoning clients’
views or problems, but rather apprehending
and affirming clients’ rights to have their own
views, attitudes, and feelings.
Attentiveness to feelings and empathic
responses to these feelings convey
understanding that clients readily discern.
Empathic responses clearly convey the
…With the majority of clients, a brief warmup period is usually sufficient. When the
preceding barriers do not apply, introductions
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Study Guide 1: Counselling and the counselling process
message, “I am with you. I understand what
you are saying and experiencing.” The
“workhorse” of successful helping persons,
empathic responding, is important not only in
Phase I of the helping process but in
subsequent phases as well. Mastery of this
vital skill (discussed extensively in Chapter 5)
requires consistent and sustained practice.
types of responses and must eliminate them
from their communication repertoires.
Toward this end, Chapter 7 identifies various
types of responses and interviewing patterns
that inhibit communication and describes
strategies for eliminating them…
Beginning social workers often fear that they
will forget something, freeze up or become
tongue-tied, talk endlessly to reduce their
anxiety, or fail to observe something crucial in
the interview that will lead to dire
consequences (Epstein and Brown, 2002).
Practice interviews such as those presented in
subsequent chapters will assist in reducing this
fear. It also helps to be aware that referred
clients need to know the circumstances of the
referral and clarify choices, rights, and
expectations before they are likely to establish
rapport with the social worker.
Authenticity, or genuineness, is yet another
social worker quality that facilitates rapport.
Being authentic during Phase I of the helping
process means relating as a genuine person
rather than assuming a contrived and sterile
professional role. Authentic behavior by
social workers also models openness, which
encourages clients to reciprocate by lowering
their defenses and relating more openly
(Doster & Nesbitt, 1979).
Encounters with authentic social workers also
provide clients with a relationship experience
that more closely approximates relationships
in the real world than do relationships with
people who conceal their real selves behind a
professional facade. A moderate level of
authenticity or genuineness during early
interviews often fosters openness. At this
level, the social worker is spontaneous and
relates openly by being nondefensive and
congruent. In other words, the social worker’s
behavior and responses match her or his inner
experiencing.
Starting Where the Client Is
Social work researchers have suggested that
motivational congruence – that is, the fit between
client motivation and what the social worker
attempts to provide – is a major factor in
explaining more successful findings in studies
of social work effectiveness (Reid &
Hanrahan, 1982). Starting with client
motivation aids social workers in establishing
and sustaining rapport and in maintaining
psychological contact with clients.
If, for example, a client appears to be in
emotional distress at the beginning of the
initial interview, the social worker might focus
attention on the client’s distress before
proceeding to explore the client’s problematic
situation. An example of an appropriate
focusing response would be, “I can sense that
you are going through a difficult time. Could
you tell me what that is like for you right
now?” Discussion of the client’s emotions
and related factors tend to reduce the distress,
which might otherwise impede the process of
exploration. Moreover, responding sensitively
to clients’ emotions fosters rapport – clients
begin to regard social workers as concerned,
perceptive, and understanding persons.
Being authentic also permits the constructive
use of humor, as elaborated in Chapter 6.
Relating with a moderate level of authenticity,
however, precludes a high level of selfdisclosure. Rather, the focus is on the client,
and the social worker reveals personal
information or shares personal experiences
judiciously. During the change-oriented phase
of the helping process, however, social
workers sometimes engage in self-disclosure
when they believe that doing so may facilitate
the growth of clients.
Rapport is also enhanced by avoiding certain
types of responses that block communication.
To avoid hindering communication, social
workers must be knowledgeable about such
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Reading D
Novice social workers sometimes have
difficulty in starting where the client is
because they worry that they will not present
quickly and clearly the services of the agency,
thus neglecting or delaying exploration of
client concerns. Practice will allow them to
relax and recognize that they can meet the
expectations of their supervisors and others
by focusing on client concerns while sharing
content about the circumstances of referrals
and their agency’s services.
language, which could cause difficulty in
understanding
even
commonplace
expressions. Where there are language
differences social workers must slow down
the pace of communication and be especially
sensitive to nonverbal indications that clients
are confused. To avoid embarrassment, some
clients who speak English as a second
language sometimes indicate that they
understand messages when, in fact, they are
perplexed.
Starting where the client is has critical
significance when you are working with
involuntary clients. Because these clients are
often compelled by external sources to see a
social worker, they frequently enter initial
interviews with negative, hostile feelings.
Social workers, therefore, should begin by
eliciting these feelings and focusing on them
until they have subsided. By responding
empathically to negative feelings and
conveying understanding and acceptance of
them, skillful workers often succeed in
neutralizing these feelings, which enhances
clients’ receptivity to exploring their problem
situations. For example, social workers can
often reduce negative feelings by clarifying the
choices available to the involuntary client. If
social workers fail to deal with their clients’
negativism, they are likely to encounter
persistent oppositional responses. These
responses are frequently labeled as resistance,
opposition to change, and lack of motivation.
It is useful to reframe these responses by
choosing not to interpret them with deficit
labels, but rather replacing them with the
expectations that these attitudes and
behaviors are normal when something an
individual values is threatened (Rooney,
2009). As children and adolescents are often
referred because adults are concerned about
their behavior, and they may therefore be
particularly resistant, the practitioner can
clarify that he or she wants to hear how things
are going from the child’s or adolescent’s
viewpoint.
Language also poses a barrier with many
ethnic minority and immigrant clients who
may have limited grasp of the English
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Study Guide 1: Counselling and the counselling process
104
Reading E
Issues and Ethics in the Helping Professions (9th ed.)
Gerald Corey, Marianne Schneider Corey, Cindy Corey and Patrick Callanan
Cengage Learning
Stamford, CT, 2015
PART I: PGS 69 – 74
PART II: PGS 75 – 77
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Study Guide 1: Counselling and the counselling process
PART I:
CHAPTER 3: VALUES AND THE
HELPING RELATIONSHIP
Clarifying your values and their
role in your work
The ability of counselors to manage their
personal values so that they do not
contaminate the counseling process is
referred to as bracketing. Counselors are
expected to be able to set aside their personal
beliefs and values when working with a wide
range of clients. Many clients will have a
worldview different from that of the
counselors, and clients bring to us a host of
problems. They may have felt rejected by
others or suffered from discrimination.
Clients should not be exposed to further
discrimination by counselors who refuse to
render services to them because of differing
values.
Introduction
The question of values permeates the
therapeutic process. In this chapter we ask
you to think about your values and life
experiences and the influence they will have
on your work. We ask you to consider the
possible impact of your values on your clients,
the effect your clients’ values may have on
you, and the possible conflicts that can arise if
you and your clients have different values. We
also hope to bring attention to the central role
culture plays in determining the values we
hold, both personally and professionally.
In other ethics courses, students sometimes
ask, “Can I put a values statement in my
informed
consent
document
that
communicates the nature of my personal
values so prospective clients can make an
informed decision about whether to enter a
professional relationship with me?” If you
were to incorporate a personal values
statement in your informed consent materials,
what would you include? Would you identify
specific areas you have difficulty maintaining
objectivity about because of the values you
hold? Would you include your position on any
of the value areas we address in this chapter?
Although perhaps well intentioned, such
disclosures put the emphasis in the wrong
place – on the counselor’s values. This can
easily convey a judgmental attitude to clients
about issues with which they may be
struggling.
Can therapists keep their values out of their
counseling sessions? The belief that
practitioners can be completely objective and
value-free is no longer a dominant perspective
in the field of psychology (Shiles, 2009). Levitt
and Moorhead (2013) contend that values not
only enter the counseling relationship but can
significantly affect many facets of the
relationship. Counselors need to understand
how their own values can permeate their work
with clients for good or ill, perhaps
unconsciously. Although clinicians may not
agree with the values of some clients,
clinicians are expected to respect the rights of
clients to hold their own views. By
demonstrating a nonjudgmental attitude
toward clients with different values, we can
remain invested in the work our clients are
doing. For example, a counselor can help a
client who is deciding whether or not to leave
a committed relationship by exploring the
client’s motivations and the possible
consequences of either decision, but
pressuring the client to choose a particular
outcome would be unethical. By honoring the
client’s self-determination, we help to
empower the client.
Counselors may have the ability to work with
a range of clients with diverse worldviews and
values. Value exploration is at the heart of
why many counselor education programs
encourage or require personal therapy for
counselors in training. Your personal therapy
sessions provide an opportunity for you to
examine your beliefs and values and to
explore your motivations for wanting to share
or impose your belief system.
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Reading E
In counseling, clients struggle to make
changes in their lives. We question the
underlying assumption that counselors have
greater wisdom than their clients and can
prescribe better ways of being happier.
Unquestionably, psychoeducation is a part of
counseling, and counselors do facilitate a
process of helping clients gain a fuller
understanding of their problems. However,
the process of counseling is meant to help
clients discover their own resources for
dealing with problems rather than listening to
advice from others. Counseling is a dialogue
between therapist and client that is meant to
further the client’s goals.


Because your values can significantly affect
your work with clients, you must clarify your
assumptions, core beliefs and values, and the
ways in which they influence the therapeutic
process. If counselors have a strong
commitment to values they rarely question,
whether these values are conventional or
unconventional, may they be inclined to
promote these values at the expense of the
clients’ exploration of their own attitudes and
beliefs? If counselors rarely reflect on their
own values, it is unlikely that they can provide
a climate in which clients can examine their
values.
The following questions may help you to
begin thinking about the role of your values in
your work with clients:










What are some potential advantages and
disadvantages in having similar life
experiences with your client?
In what ways are challenging clients to
examine their values different from
imposing values on them?
Do you think it is ever justified to
influence a client’s set of values? If so,
when and in what circumstance?
In what ways could discussing your values
with clients unduly influence the decisions
they are making?
Can you interact honestly with your
clients without making value judgments?
If you were convinced that your client was
making a self-destructive decision, would
you express your concerns, and if so, how
would you do it?
Do you think therapists are responsible
for informing clients about a variety of
value options?
How are you affected when your clients
adopt your beliefs and values?
Can you remain true to yourself and at the
same time allow your clients the freedom
to select their own values, even if they
differ from yours?
Is a referral ever justified on the basis of a
conflict of values between counselor and
client? If so, in what instances?
Do you believe certain values are inherent
in the therapeutic process? If so, what are
these values?
How does exposing your clients to your
viewpoint differ from subtly influencing
them to accept your values?
In the following sections we examine some
sample cases and issues to help you clarify
what you value and how this might influence
the goals of counseling and the interventions
you make with your clients. As you read these
examples, keep the following questions in
mind:





What is my position on this issue?
Where did I develop my views?
Am I open to being challenged by others?
Under what circumstances would I
disclose my values to my clients? Why?
What are my reasons for wanting to reveal
my values to a client?
Do my actions respect the principle of
clients’ self-determination that is
consistent with their culture?
The ethics of imposing your
values on clients
The imposition of values by the counselor is
an ethical issue in counseling individuals,
couples, families, and groups. Value
imposition refers to counselors directly
attempting to influence a client to adopt their
counselors’ values, attitudes, beliefs, and
behaviors. It is possible for mental health
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Study Guide 1: Counselling and the counselling process
practitioners to do this either actively or
passively. For example, a key element in some
addiction treatment programs is that clients
accept that there is a power higher than
themselves. Although clients are encouraged
to define for themselves what this higher
power is, some addiction counselors may be
tempted to impose their own personal beliefs
of what the higher power is, which raises
ethical issues. Counselors are cautioned about
this kind of value imposition in their
professional work in this ACA (2005)
standard:
you to work with a client who has a different
value system? Merely disagreeing with a client
or not particularly liking what a client is
proposing to do is not ethical grounds for a
referral. When you recognize instances of
such value conflicts, ask yourself this
question: “Why is it necessary that there be
congruence between my value system and that
of my client?”
Clients are in a vulnerable position and need
understanding and support from a counselor
rather than judgment. It can be burdensome
for clients to be saddled with your disclosure
of not being able to get beyond value
differences. Clients may interpret this as a
personal rejection and suffer harm as a result.
Counseling is about working with clients
within the framework of their value system. If
you experience difficulties over conflicting
personal values, the ethical course of action is
to seek supervision and learn ways to
effectively manage these differences.
Personal Values. Counselors are aware of
their own values, attitudes, beliefs, and
behaviors and avoid imposing values that are
inconsistent with counseling goals and respect
for the diversity of clients, trainees, and
research participants. (A.4.b)
School counselors receive a similar caution in
the ASCA (2010) code, which specifics that
school counselors “respect students’ values,
beliefs, and cultural background and do not
impose the counselor’s personal values on
students or their families” (A.1.c).
Consider a referral only when you clearly lack
the necessary skills to deal with the issues
presented by the client. Do not try to
convince yourself that you are working in a
client’s best interest by referring to a person
because of value conflicts. The counseling
process is not about your personal values; it is
about the values and needs of your clients.
Your task is to help clients explore and clarify
their beliefs and apply their values to solving
their problems.
In group work values imposition may come
from both the leader and members in the
group. The group leader should not shortcircuit members’ exploration of issues by
providing answers. Some members may
inappropriately respond by giving advice to
another member. Value clashes often occur
between members, and leaders have a
responsibility to intervene so that no
members can impose his or her values on
others in the group. The group leader’s central
function is to help members find answers that
are congruent with their own values, and these
answers will not be the same for all group
members.
Value conflicts may become apparent only
after a client has been working with you for
some time. Consider this scenario. You
believe you would have difficulty counseling a
woman who is considering an abortion. You
have been counseling a woman for several
months on other concerns, and one day she
discloses that she is pregnant. She wants to
explore all of her options because she is
uncertain about what to do. Would you tell
your client that you needed to refer her
because of your values pertaining to abortion?
Could such a referral be considered client
abandonment? Would it be ethical for you to
offer advice from your value position if she
Value conflicts: to refer or not to refer
Having a conflict of values does not require a
referral; it is possible to work through such
conflicts successfully. Before considering
referral, explore your part of the difficulty
through consultation or supervision. What
barriers within you would make it difficult for
108
Reading E
asks for your advice? What are the ethical and
legal aspects of imposing your values on this
client? If you cannot maintain objectivity
regarding a certain value, this is your problem
rather than the client’s, and your ethical
responsibility is to seek supervision or
consultation.
assume that such practices are
appropriate, reasonable, and acceptable.
We tell our students who want to make a
referral based on a value conflict to ask
themselves these questions: What skills
am I lacking in counseling a client
struggling with a critical life decision?
How can I determine what would ethically
justify a referral?
Discriminatory Referrals
Students often wrestle with the question of
when to refer a client: are their value
differences too great, or does the student
recognize that he or she does not have the
necessary competence to work with the client?
Insufficient training is sometimes a cover for
the real reason – the counselor’s difficulty
with the client’s values.
PART II:
Seeking Supervision Regarding Your
Values
It is not ethical to refer clients based solely on
differences of values between the counselor
and the client. Through supervision,
counselors in training can learn that they do
not have to renounce their own values, but
they must avoid using their values to steer
clients in a given direction or to make
decisions for clients. It is our job to be
invested in the process of a client’s decision
making rather than directing the person
toward outcomes that we deem as being
“right” for them.
Shiles (2009) notes that far too little has been
written about situations in which referring a
client is inappropriate, unethical, and may
constitute an act of discrimination. Shiles
asserts that inappropriate referrals have been
made for clients with differing religious
beliefs, sexual orientations, or cultural
backgrounds. Counselors rationalize these
referrals as a way to provide the client with the
best services; however, such practices may be
discriminatory. Shiles makes the following
observations:



Consider the following list of potential clients
that follows and indicate whether you believe
you could work with the client or would be
challenged in doing so because of your
countertransference or your own values.
When would you need to consider
supervision to stay neutral or to work
effectively with the client? You may think it
unlikely that you will encounter some of these
situations, but you need to be prepared to deal
with them if and when they do arise. Use this
code in the following examples:
Referrals have become common practice
among mental health service providers at
the expense of exploring other
possibilities. Mental health providers may
not be aware of the potential ethical
violation in their referral decision because
this topic is not highlighted in the
professional literature.
The overuse of client referral among
mental health providers often involves
discriminatory
practices
that
are
rationalized as ways to avoid harming the
client and practicing beyond one’s level of
competence. Discriminatory referrals
have gone unnoticed and unchallenged far
too often.
The psychological community needs to
critically examine why mental health
practitioners may refer clients over value
conflicts and why these practitioners
A = I could work with this person.
B = I would be personally challenged in working
with this person.
C = I would need to seek supervision to explore
how my values or countertransference could
affect my work with the person.
___
1. A woman who is considering an
abortion but wants help in making her
decision
___
2. A teenager who is having unsafe sex
and sees no problem with this behavior
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Study Guide 1: Counselling and the counselling process
___ 3. A person who shows little
conscience development, who is strictly
interested in his or her own advancement, and
who uses others to achieve personal aims
___ 4. A gay or lesbian couple wanting to
work on conflicts in their relationship
___ 5. A person who wants to leave his or
her partner and children to pursue a sexual
affair
___ 6. A person with fundamentalist
religious beliefs
___ 7. A woman who says that if she could
turn her life over to a higher power she would
find peace
___ 8. A couple who comes for couples
counseling while maintaining an extramarital
affair
___ 9. An interracial couple coming for
premarital counseling
___ 10. A high school student who thinks
she may be bisexual and wants to explore her
feelings around coming out
___ 11. A same-sex couple wanting to
adopt a child
___ 12. An investment counselor who
misleads clients to get a commission and who
is not held accountable
___ 13. An interracial couple wanting to
adopt a child and being faced with their
respective parents’ opposition to the adoption
___ 14. A client from another culture who
has values very different from yours (such as
arranging the marriage of their children)
___ 15. A transgender person seeking
support for coping with societal pressures and
discrimination
___ 16. An undocumented worker seeking
assistance
in
coping
with
severe
discrimination by an employer
___ 17. A male client who brings his
partner to you saying, “She is too
Americanized and I want you to make her
more willing to acknowledge my authority.”
___ 18. A woman who tells you that she
molested several children in the past but is
convinced she will not do so in the future
___ 19. A person with very strong political
opinions that differ vastly from your own
___ 20. A heterosexual man who enjoys
watching pornography with significantly
younger boys
Look back over the list, and pay particular
attention to the items you marked “B” or “C.”
What are some of the difficulties that come up
for you in these situations? If you were
seeking supervision, what questions would
you ask? Do any of these situations have legal
implications?
110
Reading F
Practical Counselling and Helping Skills: Texts and Activities for the
Lifeskills Counselling Model (6th ed.)
Richard Nelson-Jones
Sage Publications
London, UK, 2014
PART I: PGS 137 – 139
PART II: PG 471
PART III: PGS 473 – 477
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Study Guide 1: Counselling and the counselling process
PART I:
REFERRAL SKILLS
or supervisors how best to assist certain
clients. Occasions when one may refer the
client’s problem rather than the client include:
being the only counsellor available in the area;
when clients state a clear preference for
continuing working with you; and when
clients are unlikely to follow through on
referrals in any case.
In any session, counselling trainees may face
decisions about referring clients elsewhere.
Even experienced counsellors have types of
clients with whom they feel competent and
comfortable and others where they feel less
so. Lazarus states that an important
counselling principle is to ‘Know your
limitations and other clinicians’ strengths’
(Dryden, 1991: 30). He considers that referrals
should be made where other counsellors have
skills that the counsellor does not possess or
more appropriate personal styles for particular
clients. Important ethical issues surround
referral: for instance, ensuring the best
treatment for clients where other counsellors
are more expert with specific problems, such
as schizophrenia or post-traumatic stress
disorders.
The following are some skills for making
referrals.


Referral may not be an either/or matter.
Sometimes you may continue working with
clients but also refer to other counsellors and
helping professionals. Alternatively, you may
be the recipients of referrals from other
helping professionals who continue to work
with the clients concerned. I worked as a
sessional counsellor in a leading career
outplacement company where all my clients
were referred by other professionals who
continued seeing them for job search
counselling. I acted as a ‘back-stop’ for clients
whose problems were more severe or
different from the normal clientele presenting
for job search assistance.


Sometimes clients were referred to gain
additional knowledge about their problems.
For example, clients with thought-blocking
problems or sexual dysfunctions might be
referred for medical checks. Depending on
the outcome of these checks, you may gain
relevant information to help determine
whether or not to continue seeing them.

On other occasions you can refer the clients’
problem rather than the client themselves to
other counsellors and helping professionals.
For example, you can discuss with colleagues

112
Know your strengths and limitations. Be
realistic about the kinds of client with
whom you work well and those with
whom you are less skilled. Be realistic
about your workload and set appropriate
limits on it.
Build a referral network. Get to know the
resources available in the area so that you
can make good referrals. Where possible,
avoid referring ‘blind’ to someone whose
competence is unknown. Furthermore,
check whether another counsellor or
helping professional has the time available
to see the client.
Provide appropriate information. Provide the
client with relevant information about an
agency or individual to whom they are
referred: for instance, a contact person,
their telephone number and professional
address, their theoretical orientation, and
the scale of fees charged, if any.
If possible, refer early on. When you defer
referrals longer than necessary, you waste
clients’ and your own time. In addition, it
is preferable to refer clients before
emotional bonding takes place.
Avoid unnecessary referrals. Sometimes it is
better for clients to continue working with
the counsellors that they have. Tune into
anxieties and fears about seeing certain
clients. You build confidence and skills by
expanding the range of clients with whom
you can work. However, wherever
possible, you should ensure that you have
appropriate supervision and support.
Build a support network. A support network
provides professional support when you
want to refer clients’ problems rather than
the clients themselves. Your support
Reading F
network is likely to overlap with their
referral networks.
than if supervised with others. Small group
supervision also has some advantages: for
example, it gives you exposure to a greater
range of clients and enables you to develop
skills of discussing and receiving feedback on
your work from peers as well as from your
supervisor. A combination of individual
supervision and trainees participating in
counselling-skills training groups has much to
recommend it. Trainers can continue teaching
assessment skills and different interventions
in a training group. Furthermore, you can
share your experiences of working with clients
in ways that may be beneficial for all
concerned.
PART II:
SUPERVISION
Supervision literally means ‘overseeing’.
Supervisors oversee the actions or work of
others; in this context the focus is on how well
counselling trainees use essential counselling
and helping skills. Fortune and Watts state:
‘Counselling supervision is a space for
practitioners to discuss their work with
another professional with the purpose of
providing support and consultation, with the
aim of enhancing the counsellor’s work with
clients’ (2000: 5). The British Psychological
Society’s Division of Counselling Psychology
(2006) emphasizes supervision as a process of
collaborative and ongoing learning using
evidence from research and practice.
In addition, there are forms of consultative
supervision. One format is that of one-to-one
peer consultative supervision in which two
counsellors provide support and supervision
for one another by alternating the roles of
supervisor and supervisee. In peer-group
consultative supervision, three or more
counsellors share the responsibility of
providing one another with support and
supervision. Trainee and trainee counsellors
require training supervision prior to becoming
accredited. However, you can also provide
one another with consultative supervision. In
reality, much consultative supervision takes
place informally, with counsellors discussing
clients and their reactions to them with
trusted colleagues and those who have
specialist knowledge.
Carroll (1996) distinguishes between ‘training
supervision’ and ‘consultative supervision’.
Training supervision is part of the ongoing
training of trainees both on courses and
afterwards in their probationary period prior
to becoming accredited as counsellors.
Consultative supervision is an egalitarian
arrangement between one or more qualified
counsellors who meet together for the
purpose of improving the practice of at least
one of them. The major emphasis here is on
training supervision rather than on
consultative supervision, though the two
emphases overlap. Counsellor training
courses must prepare you and ensure that, in
supervision, you are able to reflect on yourself
and how you counsel.
FUNCTIONS OF SUPERVISION
The overriding goal of supervision is to aid
trainees to think and communicate as
effective counsellors and, in so doing, to
develop the skills of being your own ‘internal’
supervisor. Box 30.1 lists some of the
functions of supervision (Bond, 2010; Carroll,
1996; Fortune and Watts, 2000; Geldard and
Geldard, 2005, King, 2008; McCann, 2011;
Milne and James, 2000). I start the list by
stressing the importance of thinking
scientifically about your clients. Counsellors
as practitioner-researchers search for
evidence to support their work. Supervisors
can encourage you as trainees to create
hypotheses about what you do in counselling
PART III:
FORMATS FOR SUPERVISION
Supervision can take place either one-to-one
or with two or more trainees. Resources
permitting, my preference, especially when
trainees start seeing clients, is for individual
supervision. Advantages of individual
supervision include providing you with
adequate time to be supervised thoroughly
and the fact that you are more likely to discuss
sensitive issues regarding clients and yourself
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Study Guide 1: Counselling and the counselling process
and then to monitor and evaluate the
outcomes of your decisions. The process of
supervision involves helping you, within a safe
emotional climate, to question the adequacy
of your performance and the thinking that
precedes, accompanies and follows what you
do. Such questioning attitude requires
humility and a reasonable absence of
defensiveness for you to be able to identify,
explore and own genuine strengths and also
to be honest about the skills you need to
improve. Supervisors can also encourage you
to examine the research and professional
literature for suggestions as to what
interventions to use with which clients, under
what circumstances. Needless to say, such
literature should be examined critically rather
than unquestioningly and you should never
attempt any intervention for which you are
inadequately prepared.
11.
12.
13.
14.
15.
16.
17.
be knowledgeable about the strengths of
other counsellors.
Helping trainees to understand the
importance of developing good
professional and personal support
networks.
Developing trainees’ ethical awareness
and ethical decision-making skills.
Developing trainees’ awareness and skills
for dealing with diverse clients.
Helping trainees to address tendencies to
misperceive clients in order to meet their
own needs.
Teaching
trainees
to
address
insufficiently strong mind skills in
relation to counselling and supervision.
Developing trainees’ skills of using
supervision time wisely.
Providing trainees with knowledge of
opportunities for continuing professional
and personal development.
Dealing with the formal administrative
and evaluative aspects of supervision.
BOX 30.1 SOME FUNCTIONS OF
SUPERVISION
18.
Overall goal: Developing trainees’ skills of
being their internal supervisors.
When you start counselling clients on
placements and being supervised, you are at
the exciting stage of putting into real-life
practice the skills and learnings that you have
acquired so far. This is the moment of truth
towards which you and your trainers have
been working. For many trainees, eager
anticipation is tinged with apprehension that
you are not good enough. Though some level
of performance anxiety is realistic in
beginning counsellors, those of your who
have demanding and perfectionist rules create
unhelpful levels of anxiety that can interfere
with performance. Early on, supervisors may
have to do some ‘hand holding’ as they help
you to break the ice with real clients.
Supervisors may need to assist you to examine
insufficiently strong mind skills contributing
to performance anxiety. Throughout
supervision, supervisors should provide
emotional support in ways that encourage
self-reliance and honest self-appraisal rather
than dependence and a need for supervisor
approval.
Functions include:
1. Teaching trainees to think scientifically
about the counselling process.
2. Providing an external review of the
counselling process.
3. Providing emotional support for trainees.
4. Being available in times of crisis.
5. Helping trainees to develop strong
collaborative working relationships with
clients.
6. Helping trainees to develop specific
relationship, assessment and intervening
skills.
7. Helping trainees to apply the lifeskills
counselling model well and flexibly with
clients.
8. Developing trainees’ skills of monitoring
and evaluating their counselling practice.
9. Developing trainees’ ability to integrate
research findings into their counselling
practice.
10. Encouraging trainees to be realistic about
their own limitations and strengths, and
Supervisors can assist you to perform the joint
tasks of providing good client services and
114
Reading F
improving your essential counselling skills by
helping you to explore how well you are
conducting each stage and phase of the
lifeskills counselling model. To some extent
the supervision process parallels the
counselling process, in that your supervisor
should develop a good collaborative working
relationship with you to provide a fertile
context in which to monitor and improve
your skills. In supervision, however, the main
emphasis is on improving the mind skills and
the communication skills required for
effective counselling rather than on managing
personal problems.
professionals’ strengths. There is nothing
shameful about referring clients to colleagues
who have special areas of expertise – for
instance, in pain management or in
overcoming drug addiction. Supervision can
help you realize the value of arranging in
advance good support systems for such
purposes as dealing with emergencies, medical
considerations, clients with special problems,
and your own levels of stress and burnout.
Supervisors can also help trainees to
understand the ethical dimensions of
counselling, including issues connected with
seeing clients in placement agencies and on
counsellor training courses. Supervisors can
address issues of diversity in supervisortrainee relationships and assist you in gaining
awareness and skills for dealing with clients
whose personal characteristics differ from
your own.
Helping trainees to offer clients high-quality
counselling relationships is the primary task of
supervision’s early stages. Supervisors who
model good relationship skills are invaluable
sources of learning. It is critically important
that your supervisor assists you to develop a
comfortable interviewing style that forms a
sound base both for varying the nature of the
counselling relationship (for instance by using
skills such as questioning or challenging) and
for using more technical skills and
interventions.
While supervision should have as its focus
improving the trainees’ counselling skills, the
dividing line between supervision and
personal counselling is not clear-cut. As the
Geldards write: ‘unless a counsellor owns and
deals with their own issues, these issues are
quite likely to interfere with the counselling
process to the detriment of the client’
(Geldard and Geldard, 2005: 271-2).
Supervision should back up counselling skills
training groups in teaching you about the
important aspects of practice. You may
wrongly think you are not up to handling
some of the clients you counsel on your
placements. In many instances, placement
agencies will screen clients before referring
them to you. However, this is not always the
case and Mearns (1997), based on experience
at the University of Strathclyde’s free public
Counselling Clinic, argues that resources
spent on screening would be better diverted
to supporting trainees as they work with
challenging clients.
You may bring past patterns of unhelpful
thinking and communicating to both your
counselling
and
your
supervision
relationships. Earlier I mentioned trainees
whose demanding rules create their own
performance anxiety, which in turn makes
them less effective with clients. Assisting
trainees to identify, challenge and restate such
demanding rules might be perceived as
performing aspects of personal counselling
within the supervisory relationships. Similarly,
if supervisors and trainees become aware of
sexism or cultural prejudice, such issues
require addressing in supervision as well as,
possibly in personal counselling.
Supervisors should help you to gain a realistic
acknowledgement of your strengths and
limitations. You can develop knowledge and
confidence about when you may take on
difficult clients, provided you have access to
adequate
support
and
supervision.
Supervisors can also assist you to realize the
importance
of
acknowledging
other
The supervision literature is full of references
to counter-transference, the process by which
counsellors and trainees distort how they
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Study Guide 1: Counselling and the counselling process
perceive and behave towards clients to meet
their own needs. For instance, you may at
varying levels of awareness be encouraging
dependency, sexual interest or even distance
in some clients. Effective supervision helps
you to identify, explore and address such
distortions, at least in so far as they affect your
work with clients. Supervisors should also
identify and address their own countertransference distortions towards their
supervisees (Ladany et al., 2000).
Supervisors who adopt the lifeskills
counselling model should, as part of
supervision, be assisting you to monitor the
insufficiently strong mind skills that you may
bring to and exhibit when counselling, and
not just allow you to focus on the
insufficiently
strong
mind
and
communication skills of clients. Some trainees
require further personal counselling, a
possibility that can also be explored within
supervision.
You need to learn how to get the most out of
supervision, both when on a training course
and afterwards. You need pointers to how you
can improve your skills once supervision and
the training course end. Supervision should
help smooth out administrative aspects
related to your seeing clients in placement
agencies and provide appropriate feedback
about your progress to your training course.
116
Reading G
Personal Counseling Skills: An Integrative Approach
Kathryn Geldard and David Geldard
Charles C Thomas
Springfield, IL, 2012
PGS 256 – 267
117
Study Guide 1: Counselling and the counselling process
CONFIDENTIALITY AND OTHER
ETHICAL ISSUES
Many experienced counselors would agree
with Woolfe and Dryden who in the Handbook
of Counseling Psychology (2003) go so far as to say
that promising total confidentiality is
unethical. It is certainly true that
confidentiality is compromised by the
following:
The first part of this chapter will be devoted
exclusively to confidentiality, because it is one
of the most important ethical issues for a
counsellor. Other aspects of professional
ethics will be considered in the second part of
the chapter.


Confidentiality


Respecting client confidentiality is a
fundamental requirement for keeping trust.
For counseling to be maximally effective, the
client must feel secure in the knowledge that
what they tell the counselor is to be treated
with a high degree of confidentiality. In an
ideal world a client would be offered total
confidentiality so that they would feel free to
openly explore with the counselor the darkest
recesses of their mind, and to discuss the most
intimate details of their thoughts. As new
counselors we naively believed that we could
at all times give our clients an assurance that
what was said in a counseling session was
between them and us and would not be
discussed with others. We very soon learned
that this was an idealistic belief and found that
in practice it is generally not possible,
advisable or ethical to offer total
confidentiality.


the need to keep records;
the requirements of the counselor’s own
supervision;
the need to protect others;
working in conjunction with other
professionals;
participation in educational training
programs, conferences, workshops and
seminars; and
cases where the law requires disclosure of
information.
The above list will now be discussed in detail.
The Need to Keep Records
As explained in Chapter 23, there are
compelling reasons for keeping good records.
Counselors who work in agencies frequently
use computerized systems or centralized filing
systems for such records. This may make it
possible for other counselors and noncounseling staff such as receptionists and
filing clerks to have access to confidential
records. Some counselors omit to note certain
categories of sensitive material on their record
cards as a way of protecting clients. However,
there are obvious consequences if this policy
is adopted, as important information may be
overlooked or forgotten during subsequent
counseling sessions. Clearly, for the
protection of clients, computerized records
need to be protected by adequate security
systems. Similarly, hard copy records should
not be left lying around in places where they
can be read by unauthorized people, and
should be stored in lockable filing cabinets or
in a secure filing room.
As a counselor you may at times be troubled
by some personal difficulties regarding
confidentiality and may need to talk with your
supervisor about these. Counselors are faced
with a dilemma with regard to confidentiality.
Unless we give out clients an assurance that
what they tell us will be in confidence, they are
unlikely to be open with us. However, there
are limits to the level of confidentiality which
we can offer and we need to be clear with
clients about these limits. Most importantly,
as a counselor you need to be aware of the
limits to the confidentiality which you are
offering.
Requirements of the Counselor’s Own
Supervision
The requirements of professional supervision,
as described in Chapter 26, demand that
counselors be free to fully disclose client
ABSOLUTE CONFIDENTIALITY IS
OFTEN NOT POSSIBLE AND MAY
BE UNETHICAL.
118
Reading G
material relating to their supervisors. This is
essential if the best possible service is to be
provided, and is also necessary for the wellbeing of counselors themselves. Some
counselors openly talk with their clients about
the requirements of professional supervision
and sometimes it can be reassuring for a client
to know that their counselor is receiving
supervision.
It is also desirable for counselors to maintain
good working relationships with other helping
professionals. Sensible judgments need to be
made about what information can be, and is
disclosed, and what is withheld. It is
important to try to avoid compromising the
client’s trust in you as a counselor and to
respect their rights as a person.
WORKING IN COLLABORATION
WITH OTHER PROFESSIONALS
MAY BE ADVANTAGEOUS FOR THE
CLIENT.
COUNSELOR SUPERVISION IS
ESSENTIAL AND IN THE CLIENT’S
BEST INTERESTS.
The Need to Protect Others
Experienced counselors sometimes work with
suicidal clients, dangerous clients, and with
clients who have committed serious offenses
against other people and may possibly repeat
such
behavior.
Counselors
have
responsibilities to their clients and also to the
community. Consequently, there may be
instances where a counselor needs to divulge
information to protect a client from selfharm, or to protect a third party. For example,
if a counselor knows that their client
possesses a gun and intends to kill someone,
then it would be unethical and irresponsible if
the person at risk, the police and/or the
psychiatric authorities were not informed.
Situations in which clients pose a risk of
causing serious harm to themselves or others
are particularly challenging for the
practitioner. Consultation with a supervisor or
experienced
practitioner
is
strongly
recommended, whenever this would not
cause undue delay. In all cases, the aim should
be to ensure for the client a good quality of
care that is as respectful of the client’s capacity
for self-determination and their trust as
circumstances permit.
If you believe that it is desirable that sensitive
material be disclosed, then, you need to obtain
the client’s permission first, unless there are
unusual and compelling reasons for not doing
so. Obtaining the client’s permission involves
informing the client about what you wish to
do and why. Thus, the client is able to give
informed consent. This informed consent should
be verified in writing so there can be no
misunderstanding. Many agencies have a
standard consent form which can be used
when information is to be shared. This form
is discussed with the client and then signed by
both the client and the counselor.
Where two or more members of a family
require counseling help, family therapy may
be useful. However, if family therapy is not
available, or is considered inappropriate, then
the helping professionals involved with
members of the family are likely to achieve
more for their clients if they consult with each
other, have case conferences and work
together as a team. However, if this is to occur
the process needs to be made transparent to
all family members involved, and their
consent for sharing of information needs to
be obtained.
Working in Conjunction with Other
Professionals
Professionals such as psychiatrists, medical
practitioners, psychologists, social workers,
clergy and welfare workers frequently phone
counselors to talk with them about mutual
clients. It is sometimes in the interests of such
clients for other professionals to be
appropriately informed about their situations.
Sometimes you may discover that a client of
yours is also consulting another counseling
professional. There is rarely justification for
two counselors to work with the same client,
and so after discussion with the client it is
sensible to contact the other counselor to
decide who will take over the case. However,
as with most situations, there can be
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Study Guide 1: Counselling and the counselling process
exceptions. In a small number of cases, if
good contact is maintained between two
counselors, it may be possible for them both
to remain involved provided that they
maintain contact with each other and each set
clear boundaries and goals for their work.
unnecessarily divulged to others. It is quite
unethical to talk about clients or client
material to any person whatsoever, except in
circumstances previously described in this
chapter. What a client shares with you is
personal property and must not be shared
around, so if you do have a need to talk about
a client or their issues then talk with your
supervisor.
Educational
Training
Programs,
Conferences, Workshops and Seminars
Another
problem
area
regarding
confidentiality concerns ongoing training,
upgrading of skills and sharing of new
techniques. Counselors need to grow and
develop as people and as counselors. This can
partly be done through personal supervision
and partly through large group sharing at
conferences, seminars, workshops and case
conferences. Client material that is presented
at such events can sometimes be disguised by
changing names and other details, but often
this is not possible, particularly when videorecordings of counseling sessions are used.
Client material should never be used in this
way without the prior written consent of the
client. Moreover, there could be legal as well
as ethical problems if consent is not obtained.
WE ALL LIKE TO HAVE OUR
PRIVACY RESPCTED.
You will need to make your own decisions, in
consultation with your supervisor, about how
best to deal with the confidentiality issue. Our
policy is to be up-front with clients and to
explain the limits of confidentiality as they
apply. For example, when we worked for an
agency, that agency had a policy regarding
confidentiality. Consequently, we needed to
inform clients of that policy. As private
practitioners, if we believe that it would be
useful or sensible to divulge information for
an ethically acceptable and professional
reason, then we obtain the client’s informed
consent, as we would if we were working for
an agency.
Where the Law Requires Disclosure of
Information
Remember that client confidentiality may be
limited by legal intervention. Sometimes
counselors are subpoenaed to give evidence in
court and in such cases withholding
information may be in contempt of court.
Additionally, mandatory reporting is required
in many jurisdictions by counselors with
regard to issues such as child abuse.
Professional ethics
The issue of confidentiality has been
discussed in some detail. However, there are
many other ethical issues for counselors, and
a new counselor needs to be informed of
these. Many counselors belong to professional
associations with codes of ethical conduct.
These codes are readily available on request,
and it is sensible for a new counselor to read
through the relevant code for the relevant
profession.
Respecting the Client’s Right to
Privacy
Clearly, from the preceding discussion, there
are many reasons why confidentiality in the
counseling situation is limited. However, it is
the counselor’s task to ensure that
confidentiality is preserved as far as is
sensibly, legally and ethically possible. Assure
your clients that you will do this to the best of
your ability, because they need to feel that
whatever they share with you is protected
information which will not be carelessly or
Some important ethical issues are included in
the list below, and these will be discussed in
subsequent paragraphs:

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respect for the client
limits of the client-counselor relationship
responsibility of the counselor
counselor competence
referral
Reading G
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

Limits
of
the
Client-Counselor
Relationship
In all our relationships we set limits. Each of
us has a boundary around us to preserve our
identity as an individual. The strength of that
boundary, and its nature, depends on who the
relationship is with, and on the context of the
relationship. The client-counselor relationship
is a special type of relationship, established by
the client for a particular purpose. The client
enters into the relationship entrusting the
counselor with their well-being and expecting
that the counselor will, throughout the
relationship, provide them with a safe
environment in which they can work on their
problems.
termination of counseling
legal obligations
self promotion.
Respect for the Client
Regardless of who the client is, and regardless
of their behavior, the client has come to you
for help and deserves to be treated as a human
being of worth. If you treasure your client,
through feeling valued, they will be given the
optimum conditions in which to maximize
their potential as an individual. Most helping
professionals agree that within each of us is
the potential for good, and for that potential
to be realized we need to feel O.K. about
ourselves. Counselors therefore have a
responsibility to help their clients to feel O.K.
about themselves, and to increase their
feelings of self-worth.
As discussed previously, the client-counselor
relationship is not an equal relationship and
inevitably, whether the counselor wishes it or
not, they are in a position of power and
influence. They are often working with clients
who are in highly emotional states and are
consequently very vulnerable. The way in
which a counselor relates to a client is
uncharacteristic human behavior. A counselor
devotes most of their energy to listening to
and understanding the client, and so the
person sees only a part of the counselor’s
character. In these circumstances, a client may
perceive a counselor as unrealistically caring
and giving. The counselor’s power and the
client’s biased perception combine to make
the client very vulnerable to offers of
friendship or closeness.
GIVE THE CLIENT THE RESPECT
YOU WOULD LIKE YOURSELF.
If we try to impose our own moral values on
clients, then we are likely to make them feel
judged and to damage their self worth.
Moreover, they are likely to reject us as
counselors and to reject our values too.
Paradoxically, if we are able to accept our
clients, with whatever values they have, we are
likely to find that as time passes they will move
closer to us in their beliefs. This is inevitable
because, as counselors, we are, whether we
like it or not, models for our clients. We have
a responsibility to be good models. In this
regard, it can be useful to create opportunities
for clients to give feedback about their
experience of the counseling process. This
will demonstrate respect for their views and
their right to have some influence in the
counseling relationship.
The counselor is also vulnerable. In the
counseling relationship, the client often shares
their innermost secrets, and so inevitably
there may develop a real closeness between
the person and the counselor. Counselors
learn to be empathic, and so they develop
special relationships with their clients. If they
are not careful they, too, become vulnerable
to offers of closer relationships than are
appropriate. Counsellors therefore need to be
careful not to discount signposts that the
counseling
relationship
is
being
compromised.
We need to remember that the client’s
interests must take precedence over the
counselor’s during the counseling process. It
is not ethical to use counseling sessions with
people who seek help to work through our
own issues. The correct time for working
through our issues is in supervision sessions.
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Study Guide 1: Counselling and the counselling process
Clearly, the counselor has a responsibility to
the client and needs to directly address the
client’s request for counseling help. When a
client comes to you for confidential help, you
have an implied contract with them to give
them that, unless you tell them something to
the contrary. You cannot ethically fulfil the
client’s needs if doing so would:
COUNSELORS ARE VULNERABLE
TOO!
Unfortunately, it is almost always unhelpful
and damaging to the client when the clientcounselor relationship is allowed to extend
beyond the limits of the counseling situation.
If such an extension occurs, the counselor’s
ability to attend to the client’s needs is
seriously diminished, and there may well be
serious psychological consequences for the
client.



As a counselor, it may at times be hard to
refuse invitations to get closer to your clients
than the counselor situation allows.
Remember that if you do not set appropriate
boundaries you will be merely satisfying your
own needs at the expense of the client. You
will have abused your special position of trust
as a professional, and you will have to live
with that knowledge, and with any more
serious consequences. When counselors
breach appropriate boundaries they may
damage or diminish the usefulness of the
counseling process and reduce the possibility
that the person seeking help will in the future
seek further counseling help. Be aware of the
danger signals if you notice that your
relationship with a client is becoming too
close, and bring the issue into the open by
discussing it with your supervisor and with the
client, if that is appropriate.

involve working in opposition to the
policies of the organization that employs
you
involve a breach of the law
put other members of the community at
risk
be impossible for you personally.
However, in these situations you need to be
clear with your client about your own
position, so that they understand the
conditions under which they are talking to
you.
Counselors who are employed by an
organization or an institution have a
responsibility to that employing body. All the
work they do within that organization or
institution needs to fulfil the requirements of
the employing body, and to fit in with the
philosophical expectations of the employing
body. For example, when we both worked for
the Child and Youth Mental Health Service in
Queensland, it was our responsibility to
comply with the policies of the Queensland
Department of Health. If we had not been
able to do that, then we would have had an
ethical responsibility to discuss the issue with
our employers, or to resign.
Counsellors need to exercise care if they touch
a client in any way. Unwelcome touching is
not only unethical, it may also be construed as
sexual harassment.
Responsibility of the Counselor
Counselors frequently experience a sense of
conflict between their responsibilities to the
client, to the agency that employs them and to
the community. You will at times need to
make your own decisions about which of
these responsibilities needs to take
precedence, and in our view the decision is
unlikely to always be the same. If you are in
doubt about any particular decision, consult
your supervisor.
WE HAVE A RESPONSIBILITY TO
THE CLIENT, OUR EMPLOYER,
THE COMMUNITY, AND
OURSELVES.
Counselors have to be aware at all times of
their responsibilities to the community at
large. As discussed earlier, this raises problems
with regard to confidentiality. Whenever a
member of the community is at risk, or
property is likely to be damaged, or other
illegal actions are likely to occur, or have
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Reading G
occurred, then a counselor needs to make a
decision regarding what action is needed.
Often such decisions do not involve choosing
between black and white, but rather between
shades of grey, and sometimes counselors
find it difficult to decide what is most
appropriate in order to serve the needs of the
client and community in the long term. At
these times the sensible approach is for a
counselor to talk through the ethical issues
with their supervisor.
It may sometimes be appropriate for a
counselor to continue seeing a client while
under intensive supervision, instead of
referring. If this happens, then the counselor
has a responsibility to inform the client.
Often, referral is useful where people have
special needs. For example, people with
particular disabilities, people from other
cultures and people who speak another
language may benefit from referral to an
agency (or professional) that can provide for
their specific needs.
Counselor Competence
A counselor has a responsibility to ensure that
they give the highest possible standard of
service. This cannot be done without
adequate training and supervision. All
counselors need to attend to their own
professional development and to have
supervision from another counselor on a
regular basis. Failure to do this is certain to
result in the counselor’s own issues intruding
into the counseling process, and this will be to
the detriment of the client (see Chapter 26).
When referring clients to others, it may be
useful to contact the professional to whom
the referral is being made, with the client’s
permission, to ensure that the referral is
acceptable and appropriate.
Termination of Counseling
Termination of counseling needs to be carried
out sensitively and with appropriate timing
(see Chapter 10). It is not ethical to terminate
counseling at a point where the client still
needs further help. If for some unavoidable
reason (such as leaving the district) you need
to do this, then it is incumbent upon you to
make a suitable referral to another counselor
who can continue to give the necessary
support.
A counselor also needs to be aware of the
limits of their competence. We all have limits
professionally and personally, and it is
essential that as counselors we are able to
recognize our limits and to be open with
people who seek our help about those limits.
The client has a right to know whether they
are seeing someone who has, or does not
have, the necessary abilities to give them the
help they require.
Legal Obligations
Counselors, like all other professionals and
every other member of the community, need
to operate within the law. Therefore, as a
counselor, you need to familiarize yourself
with the relevant legal requirements for your
profession. It is particularly important to
know whether mandatory reporting of
specific behaviors such as suspected child
abuse is required.
Referral
When a client’s needs cannot be adequately
met by a counselor, then that counselor has a
responsibility to make an appropriate referral,
in consultation with the client, to another
suitable professional. However, it is not
appropriate for a counselor to avoid all
difficult and un-enjoyable work by excessively
referring people to others. There is a
responsibility on all counselors to carry a fair
load, and to be sensible about referral
decisions. Such decisions are best made in
consultation with a supervisor.
Self-Promotion
Most professional associations for counselors
have specific rules about advertising. There is
clearly an ethical issue with regard to the way
in which counselors describe themselves and
their services. It is unethical for a counselor to
make claims about themselves or their
services which are inaccurate or cannot be
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Study Guide 1: Counselling and the counselling process
substantiated. Counselors who do this not
only put the people who seek help at risk, but
may also face the possibility of prosecution.
Learning Summary



For counseling to be most effective, a
high degree of confidentiality is required.
Confidentiality is limited by the need to
keep records, professional supervision,
the law, the protection of others,
participation in training conferences and
cooperation with other professionals.
Professional ethics relate to issues such as
respect for the client; limits to the
relationship with the client; responsibility
to the client, the employing agency and
the community; competence; referral to
others; termination of counseling; legal
obligations; and self promotion.
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